Individual provider Active NPI

Angela Rosalia Banks Paulino, MD

  • Internal Medicine Physician
  • Skowhegan, ME
National Provider Identifier
1942795885
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25815 Issued in ME
Practice address
46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481
Phone
(207) 474-0905
Fax
(207) 474-6930
NPI assigned
Jun 23, 2018
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD25815 ME Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD25815 ME

Addresses

Primary practice location

46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-0905

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713000501 ME Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 7810378544 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25815MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Jul 29, 2022 Accepting new patients
Redington-Fairview General Hospital Hospice and Palliative Medicine CurrentSince Jul 29, 2022 Accepting new patients
Woodlands Senior Living of Madison LLC Past Accepting new patients

Locations

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

46 Fairview Ave
Ste 111
Skowhegan, ME 04976
Phone (207) 474-3320

Interoperability endpoints

  • Direct secure messaging: angela.banks-paulino@rmpc.direct.rfgh.net

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": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1942795885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-0905",
            "fax_number": "207-474-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE STE 111",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-0905",
            "fax_number": "207-474-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS PAULINO",
        "first_name": "ANGELA",
        "middle_name": "ROSALIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD25815",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "ME",
            "license": "MD25815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.