HOLLY HAEBERLEIN – Dermatology Physician, NPI 1932537800

HOLLY HAEBERLEIN is a healthcare provider. based in Bangor, Maine. specializing in NURSE PRACTITIONER. They hold a License No. CNP131096 (ME). The NPI Number for HOLLY HAEBERLEIN is 1932537800

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY HAEBERLEIN
NPI
1932537800
Phone
(207) 942-0669
Address
90 RIDGEWOOD DR
Enumeration Date
31 October 2013
Last Update Date
31 October 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2079420669
Graduation Year
2013 (13 years ago)
PAC ID
1254563935
Group Practice PAC ID
7315092541
Professional Enrollment ID
I20140411000110
Address ID
ME044733446OR381XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

1,871 NURSE PRACTITIONER in ME

Provider Addresses for HOLLY HAEBERLEIN

  • 90 RIDGEWOOD DR

    BANGOR, ME 044012652

    Phone: (207) 942-0669

    Fax: (207) 947-3143

    Type: Location

  • 23 BRENTWOOD AVE

    BANGOR, ME 044014201

    Phone: (207) 942-0669

    Fax: (207) 947-3143

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 111 Open Payments records for all available years, with a total value of $2,597.

Total Amount is formed as General ($2,597) + Research ($0) + Ownership ($0) = $2,597.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($415).

Total Amount

$2,597

General + Research + Ownership

Payments

111

Total payment records

General Amount

$2,597

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-04-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140411000110INurse PractitionerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes840637$0
17003Destruction of precancer skin growth, 2-14 growths576134$0
11102Biopsy of related skin growth, first growth370315$0
17000Destruction of precancer skin growth, 1 growth251215$0
17110Destruction of skin growth, 1-14 growths202181$0
View full utilization report →

Insurance plans in this area (ZIP 04401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315092541View full group profile
NameSpecialtyState
D E R M A T O L O G YME
Nurse PractitionerME
Physician AssistantME
Physician AssistantME
Nurse PractitionerME
Physician AssistantME
D E R M A T O L O G YFL

Reviews

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Frequently asked questions

Can I verify HOLLY HAEBERLEIN with an NPI only?
You can start verification with NPI 1932537800 for HOLLY HAEBERLEIN, then check state licensing separately.
Can I rely on HOLLY HAEBERLEIN being an active provider?
As of the registry snapshot, HOLLY HAEBERLEIN is marked active.
What taxonomy line describes HOLLY HAEBERLEIN?
For research purposes, treat HOLLY HAEBERLEIN as Dermatology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for HOLLY HAEBERLEIN?
HOLLY HAEBERLEIN's geographic hint is Bangor, Maine in our summary view.
Is the information about HOLLY HAEBERLEIN up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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