Brianna Boutin, NP
Individual provider Active NPI Nurse Practitioner · Falmouth, ME
NPI 1962854786 · NPPES record last updated Dec 26, 2024
Key facts
- NPI
- 1962854786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- CNP161075 (ME)
- Practice address
- 19 Northbrook Dr
Falmouth, ME 04105-1381 - Phone
- (802) 523-3054
- Fax
- (207) 910-9620
- NPI assigned
- Jul 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Oct 29, 2025 through Oct 29, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Health Services LLC | Current |
Accepting new patients |
Locations
8 Hill Way
Ste A
Cape Elizabeth, ME 04107
Phone (207) 799-9950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CNP161075 | ME | Yes |
Addresses
Primary practice location
19 Northbrook Dr
Falmouth, ME 04105-1381
Mailing address
19 Northbrook Dr
Falmouth, ME 04105-1381
Phone (802) 523-3054
Other names
- Brianna Mauro
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brianna@beacondpc.com | Direct |
Other providers in Falmouth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.