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NORTHEAST NEPHROLOGY PA
NPI 1336145200
Internal Medicine - Nephrology in Bangor, ME

Active since June 24, 2005CLIA 20D0089363 · Microscopy
417 STATE ST, STE 321, BANGOR, ME 04401(207) 973-8833(207) 973-8836 Get Directions Write a Review

NPPES record last updated: May 4, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Northeast Nephrology Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEAST NEPHROLOGY PA (NPI 1336145200) is a healthcare organization registered as a nephrology in Bangor, Maine and active in the NPI registry since June 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2028 and lists Stephen G Comeau, President, as its authorized official.

NPPES Registry Identity

NPI1336145200
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameNORTHEAST NEPHROLOGY PA
Location Address417 STATE ST, STE 321Bangor, ME 04401-6638
Mailing Address417 State St, Ste 321Bangor, ME 04401-6638 · (207) 973-8833 · Fax (207) 973-8836
Phone(207) 973-8833
Fax(207) 973-8836
Organization SubpartNo
Authorized OfficialStephen G ComeauPresident · (207) 973-8833
Enumeration DateJune 24, 2005
Last NPPES UpdateMay 4, 2010
✔ NPI 1336145200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
417 STATE ST, Bangor, ME 04401
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Other Identifiers 2

Medicare PINMM7506ME
Medicaid132020000ME

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northeast Nephrology Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Northeast Nephrology PA, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Hui Liu, M.D.
Nephrology
NPI 1487898235
417 STATE ST STE 321
Bangor, ME 04401
(207) 973-8833
✔ PECOS✔ Accepts MedicareSame address
Mihail Soare, M.D.
Nephrology
NPI 1194906859
417 STATE ST SUITE 321
Bangor, ME 04401
(207) 262-6051
✔ PECOS✔ Accepts MedicareSame address
Amanda Theriault, APRN-CNP
Nurse Practitioner
NPI 1548997521
417 STATE ST STE 321
Bangor, ME 04401
(207) 973-8833
✔ PECOS✔ Accepts MedicareSame address
Stephen Comeau, M.D.
Nephrology
NPI 1538165402
417 STATE ST STE 321
Bangor, ME 04401
(207) 973-8833
✔ PECOS✔ Accepts MedicareSame address
Michael Mcgoldrick, MD
Nephrology
NPI 1285749085
417 STATE ST SUITE 321
Bangor, ME 04401
(207) 973-8833
✔ PECOS✔ Accepts MedicareSame address
Manish Nepal, MD
Nephrology
NPI 1982862751
417 STATE ST SUITE 321
Bangor, ME 04401
(207) 973-8833
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 20D0089363

Northeast Nephrology PA · Bangor, ME
Active · expires Aug 31, 2028
CLIA Number20D0089363
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorStephen Comeau
Laboratory Phone(207) 973-8833
Laboratory LocationNortheast Nephrology PA417 State St, Bangor, ME 04401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Nephrology PA's NPI number?

The NPI number for Northeast Nephrology PA is 1336145200. It was assigned to this organization in the NPPES registry on June 24, 2005.

Where is Northeast Nephrology PA located?

Northeast Nephrology PA is located at 417 State St Ste 321, Bangor, ME 04401. The listed phone number is (207) 973-8833.

What is Northeast Nephrology PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Northeast Nephrology PA enrolled in Medicare?

Yes. Northeast Nephrology PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northeast Nephrology PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Northeast Nephrology PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (5) and Nurse Practitioner (1). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Northeast Nephrology PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 20D0089363) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northeast Nephrology PA accept?

Health plans from Anthem Blue Cross and Blue Shield list Northeast Nephrology PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northeast Nephrology PA was last updated on May 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.