Micah Gordon Malenfant, DNP, PMHNP-BC, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP201195 Issued in ME

Practice address

15 Pleasant Hill Rd Ste 204
Scarborough, ME 04074-7678

Phone

(207) 600-4025

Fax

(207) 600-9625

NPI assigned

Jul 23, 2020

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seaside Family Health Care LLC PAGroup PAC ID 2163761032, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seaside Family Health Care LLC PA

  • Family Nurse Practitioner
  • Old Orchard Beach, ME
  • NPI 1972093011
  Medicare reassignment Care Compare group
• Summit Wellness Solutions, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Scarborough, ME
  • NPI 1073343729
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1902415268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PLEASANT HILL RD STE 204",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PLEASANT HILL RD STE 204",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747678",
            "telephone_number": "207-600-4025",
            "fax_number": "207-600-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALENFANT",
        "first_name": "MICAH",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-23",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP201195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mainehealth (MMC Cancer Risk & Prevention - Adult Oncology)
• Mainehealth
• Mainehealth (Maine Medical Partners MaineHealth Cardiology)
• Mainehealth (Maine Children's Cancer Program)
• Jennifer K Major, DPT
• Jordan Malenke, MD
• Lillian R Mandl, APRN
• Jeffrey M Maneval, MD
• Samara Manges
• Katharine Anne Manning, MD

• Psychiatric/Mental Health Nurse Practitioner in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.