MICHAEL C TAVARES PMHNP NPI 1558089276

NPI Information

  • NPI: 1558089276
  • Provider Name: MICHAEL C TAVARES, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 181 CORPORATE DR
    BANGOR, ME
    ZIP 04401
  • Phone: (207) 992-2636

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NPI Details

Michael C Tavares, PMHNP is a psychiatric/mental health nurse practitioner in Bangor, ME with 3 years of experience. Michael C Tavares, PMHNP NPI is 1558089276. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:2022

The provider's business location address is:

181 CORPORATE DR
BANGOR, ME
ZIP 04401-314
Phone: (207) 992-2636

The NPI 1558089276 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/18/2022 and was last updated on 10/28/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11022135FLORIDANo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthCNP241426MAINEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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