Individual provider Active NPI

Sylvia Park, MD

  • Psychiatry Physician
  • Portland, ME
National Provider Identifier
1962716571
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD23677 Issued in ME
Practice address
53 Baxter Blvd Ste 3
Portland, ME 04101-1827
Phone
(207) 613-4115
NPI assigned
Aug 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD23677 ME Primary
Psychiatry Physician 2084P0800X 24336 NH

Addresses

Primary practice location

53 Baxter Blvd Ste 3
Portland, ME 04101-1827

Mailing address

53 Baxter Blvd Ste 3
Portland, ME 04101-1827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230511001550 ME Practitioner - Psychiatry 0345565867 Reassigns benefits to 1 organization
I20251030003864 NH Practitioner - Psychiatry 0345565867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

16 5TH St
Dover, NH 03820-2930
Phone (603) 883-0005

53 Baxter Blvd
Portland, ME 04101-1827
Phone (603) 883-0005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24336NHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center of Nashua Inc CurrentSince Mar 10, 2023 Accepting new patients

Locations

53 Baxter Blvd
Ste 3
Portland, ME 04101
Phone (207) 613-4115

53 Baxter Blvd
Portland, ME 04101
Phone (207) 245-1648

11 Baxter Blvd
Fl 2
Portland, ME 04101
Phone (207) 306-9900

16 Fifth St
Dover, NH 03820
Phone (603) 617-4799

24 Front St
Exeter, NH 03833
Phone (603) 772-3900

1 Main St
Nashua, NH 03064
Phone (603) 689-7978

100 Eileen Dondero Foley Ave
Ste 302
Portsmouth, NH 03801
Phone (603) 427-6868

Interoperability endpoints

  • Direct secure messaging: ccn.sylviapark@140126.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1962716571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 BAXTER BLVD STE 3",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BAXTER BLVD STE 3",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011827",
            "telephone_number": "207-613-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SYLVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD23677",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "24336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.