Individual provider Active NPI

Amanda Deluck, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1972986826
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP151060 Issued in ME
Practice address
268 Stillwater Ave
Bangor, ME 04401-3945
Phone
(207) 973-5295
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP151060 ME Primary

Addresses

Primary practice location

268 Stillwater Ave
Bangor, ME 04401-3945

Mailing address

268 Stillwater Ave
Bangor, ME 04401-3945

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909001963 ME Practitioner - Nurse Practitioner 5496062390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

329 Bath Rd
Brunswick, ME 04011-2673
Phone (207) 373-3177

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Sep 1, 2020 Accepting new patients
Acadia Hospital Corp CurrentSince Jul 12, 2015 Accepting new patients
Eastern Maine Medical Center CurrentSince Apr 15, 2017 Accepting new patients
Acadia Healthcare, Inc CurrentSince Mar 1, 2018 Accepting new patients
Eastern Maine Medical Center CurrentSince Apr 15, 2017 Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

23 Water St
Ste 203
Bangor, ME 04401
Phone (207) 973-6620

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

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

222 Saint John St
Ste 113
Portland, ME 04102
Phone (207) 772-2440

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 5

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1972986826",
    "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"
        },
        {
            "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": "207-973-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCK",
        "first_name": "AMANDA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP151060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.