Warren Benjamin Black

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP141098 Issued in ME

Practice address

268 Stillwater Ave
Bangor, ME 04401-3945

Phone

(207) 973-6100

NPI assigned

Oct 3, 2014

Last updated

Oct 3, 2014By 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, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Acadia Hospital Corp.Group PAC ID 7719878495, 88 clinicians

Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Rumford HospitalGroup PAC ID 3870583511, 37 clinicians

Sebasticook Valley HealthGroup PAC ID 3476462797, 35 clinicians

Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

The Blue Hill Memorial HospitalGroup PAC ID 7911991336, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score

86.22 of 100Reported as group

Quality

75.39

Promoting interoperability

84

Improvement activities

40

Cost

75.32

Merit-based Incentive Payment System (MIPS)

Final score

84.1 of 100Reported as group

Quality

64.8

Promoting interoperability

96

Improvement activities

40

Cost

68.87

Merit-based Incentive Payment System (MIPS)

Final score

85.02 of 100Reported as group

Quality

59.99

Promoting interoperability

99

Improvement activities

40

Cost

74.25

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

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.

• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment Care Compare group NPD
• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment Care Compare group NPD
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment Care Compare group NPD
• Rumford Hospital

  • Critical Access Hospital
  • Rumford, ME
  • NPI 1205991122
  Medicare reassignment Care Compare group NPD
• Sebasticook Valley Health

  • Critical Access Hospital
  • Pittsfield, ME
  • NPI 1457461477
  Medicare reassignment Care Compare group NPD
• The Blue Hill Memorial Hospital

  dba Northern Light Blue Hill Hospital

  • Critical Access Hospital
  • Blue Hill, ME
  • NPI 1023057809
  Medicare reassignment Care Compare group
• Bridgton Hospital

  • Critical Access Hospital
  • Bridgton, ME
  • NPI 1154370153
  Medicare reassignment NPD
• Charles a Dean Memorial Hospital

  dba Northern Light C A Dean Hospital

  • Critical Access Hospital
  • Greenville, ME
  • NPI 1659388213
  Medicare reassignment NPD
• Maine Coast Regional Health Facilities

  dba Northern Light Maine Coast Hospital

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Medicare reassignment NPD
• MRH Corp.

  dba Mayo Regional Hospital

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Medicare reassignment NPD
• The Aroostook Medical Center

  dba Northern Light A.R. Gould Hospital

  • General Acute Care Hospital
  • Presque Isle, ME
  • NPI 1396858999
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1932502002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "address_2": "P.O. BOX 422",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WARREN",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP141098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manoach Bizumuremyi
• BJ's Wholesale Club Inc.
• Thorarinn Arni Bjarnason, MD
• David Harlan Bjork, DC
• Mary Elizabeth Black
• Tina Marie Blackley, APRN FNP-C
• Hailey E Blackwood, FNPC
• Royce Blackwood, PA-C
• Shirley Blake, PT
• Genevieve Blanchard

• Psychiatric/Mental Health Nurse Practitioner in Bangor, ME
• Providers in Bangor, 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 Oct 3, 2014; 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.