Individual provider Active NPI

Melissa Burch, MD

  • Pediatrics Physician
  • Bangor, ME
National Provider Identifier
1972559359
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
014979 Issued in ME
Practice address
133 Corporate Dr
Bangor, ME 04401-4312
Phone
(207) 945-1155
Fax
(207) 945-5063
NPI assigned
May 26, 2006
Last updated
May 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 014979 ME Primary

Addresses

Primary practice location

133 Corporate Dr
Bangor, ME 04401-4312

Mailing address

43 Whiting Hill Rd
Suite 300
Brewer, ME 04412-1005
Phone (207) 973-5035

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
I20040210000323 ME Practitioner - Pediatric Medicine 8921992157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014979MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince May 29, 2011 Accepting new patients
Eastern Maine Medical Center CurrentSince May 29, 2011 Accepting new patients

Locations

133 Corporate Dr
Bangor, ME 04401
Phone (207) 941-1155

489 State St
Bangor, ME 04401
Phone (207) 973-8837

Organizations & group practices 2

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1972559359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "address_2": "SUITE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 CORPORATE DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014312",
            "telephone_number": "207-945-1155",
            "fax_number": "207-945-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "014979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.