Mary Tedesco-Schneck, PNPC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CNP81676 Issued in ME

Practice address

404 State St
Suite 310
Bangor, ME 04401-6623

Phone

(207) 973-8853

Fax

(207) 973-6966

NPI assigned

Sep 24, 2006

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Penobscot Community Health Center

  dba Penobscot Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1427169010
  Medicare reassignment NPD
• Penobscot Community Health Center

  dba Adult Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1083259410
  NPD
• Penobscot Community Health Center

  dba Penobscot Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1568555498
  NPD
• Penobscot Community Health Center

  dba Warren Center

  • Hearing and Speech Clinic/Center
  • Bangor, ME
  • NPI 1285685628
  NPD (past)

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1932209426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 STATE ST",
            "address_2": "SUITE 310",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016623",
            "telephone_number": "207-973-8853",
            "fax_number": "207-973-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 STATE ST",
            "address_2": "SUITE 310",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016623",
            "telephone_number": "207-973-8853",
            "fax_number": "207-973-6966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Telcom Dr",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013072",
            "country_code": "US",
            "telephone_number": "207-947-0147",
            "fax_number": "207-990-3365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDESCO-SCHNECK",
        "first_name": "MARY",
        "credential": "PNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP81676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Ranger Taylor, O.D.
• Jennifer Wynne Taylor, PMHNP-BC
• Leeanne Taylor, MS, LADC
• Maria Elizabeth Taylor, LMSW-CC
• Mary E Taylor, PA-C
• Ledor Friday Teekate
• Jacqueline Teele, CCP
• Nina Tekelenburg
• Lucus Temple, LMSW-CC
• Diane Alicia Tennies, PH.D.

• Pediatric Nurse Practitioner in Bangor, ME
• Providers in Bangor, ME by specialty
• Pediatric Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.