Individual provider Active NPI

Rebecca Bolduc, FNP-C

  • Nurse Practitioner
  • Farmington, ME
National Provider Identifier
1932850252
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP211307 Issued in ME
Practice address
111 Franklin Health CMNS
Farmington, ME 04938-6144
Phone
(207) 778-4922
NPI assigned
Jan 18, 2022
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP211307 ME Primary

Addresses

Primary practice location

111 Franklin Health CMNS
Farmington, ME 04938-6144

Mailing address

111 Franklin Health CMNS
Farmington, ME 04938-6144
Phone (207) 778-4922

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220217001838 ME Practitioner - Nurse Practitioner 0446643324

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP211307MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 1, 2022 Accepting new patients
Mainehealth CurrentSince Mar 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients

Locations

111 Franklin Health Cmns
Farmington, ME 04938
Phone (207) 778-3326

181 Franklin Health Cmns
Farmington, ME 04938
Phone (207) 778-3326

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • Direct secure messaging: rbolduc296205@direct.mmc.mainehealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1932850252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FRANKLIN HEALTH CMNS",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386144",
            "telephone_number": "207-778-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FRANKLIN HEALTH CMNS",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386144",
            "telephone_number": "207-778-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDUC",
        "first_name": "REBECCA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP211307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, ME

Sources for this page

Verify at the official NPI Registry.