Amelia Fonseca Escudero

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD19646 Issued in ME

Practice address

268 Stillwater Ave
Bangor, ME 04401-3945

Phone

(207) 973-6100

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of MaineGroup PAC ID 7517875131, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• State of Maine

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1699776146
  Medicare reassignment Care Compare group NPD
• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment NPD
• State of Maine

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD
• State of Maine

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1184020091
  NPD
• Acadia Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1568477297
  NPD (past)
• Steward Medical Group, Inc.

  • Specialist
  • Brighton, MA
  • NPI 1265745301
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1942422399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "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": "FONSECA ESCUDERO",
        "first_name": "AMELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "225623",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD19646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Anne Floyd, MD, MPH
• Amanda Aarron Fogarty, LCPC
• Ruth A Fogler, M.D.
• Kathryn A Foley, FNPC
• Sarah E Folsom, PAC
• Jason Michael Fonseca, ACNPC-AG
• Jaclyn Kimberly Foraker, FNP-C
• Katherine Rachel Forand, LCSW
• Christopher H Ford, DMD
• Renee Michelle Ford, PHARMD

• Psychiatry Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.