DR. FLAVIAN MARK LUPINETTI (NPI# 1063486371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063486371 |
| Entity Type | Individual |
| Full Name | DR. FLAVIAN MARK LUPINETTI |
| Credential | M.D. |
| Practice Address |
417 State St Suite 421 Bangor ME 04401-6630 |
| Mailing Address |
43 Whiting Hill Rd Suite 300 Brewer ME 04412-1005 |
| Practice Telephone | 2079735293 |
| Practice Fax Number | 2079735293 |
| Mailing Fax Number | 2079735293 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2017-11-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD2011-0212 | NM | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 19850 | ME | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 0101246909 | VA | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 26248 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1023732750001 | 05 |
| Street Address |
417 STATE ST SUITE 421 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295731131 | David Lawrence Levy | Internal Medicine | 417 State St, Ste 321, Bangor, ME 04401-6638 | 2005-06-24 |
| 1891304473 | Kristina Lynn Leonard | Nurse Practitioner | 417 State St, Bangor, ME 04401-6630 | 2020-07-29 |
| 1528558830 | Kelli Megan Nicole Huth | Physician Assistant | 417 State St, Bangor, ME 04401-6630 | 2018-05-11 |
| 1770005670 | Caitlin Dombrowski | Psychologist | 417 State St, Bangor, ME 04401 | 2017-07-12 |
| 1497281844 | Jamie Hight | Physician Assistant | 417 State St, Webber East Suite 221, Bangor, ME 04401-6630 | 2017-05-04 |
| 1255871240 | Courtney Lee Taylor | Nurse Practitioner | 417 State St, Webber East, Suite 421, Bangor, ME 04401-6630 | 2017-02-24 |
| 1083153977 | Tyler Munro | Physician Assistant | 417 State St, Suite 340, Bangor, ME 04401 | 2017-02-13 |
| 1457802530 | Carmen Jean Van Dusen | Nurse Practitioner | 417 State St, Suite 330, Bangor, ME 04401-6630 | 2016-10-24 |
| 1992187199 | Erin Borges | Physician Assistant | 417 State St, Webber West Suite 340, Bangor, ME 04401-6630 | 2015-06-24 |
| 1750789897 | Dahl Chase Diagnostic Services | Clinical Medical Laboratory | 417 State St, Suite 440, Bangor, ME 04401-6630 | 2014-12-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457337172 | John Dean Klemperer | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401-6639 | 2005-12-15 |
| 1205324415 | Ashley Eileen Sirois | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401-6639 | 2018-04-24 |
| 1912417817 | Kathleen R Marcoux | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401-6639 | 2017-10-05 |
| 1134417462 | David Pantino | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401 | 2011-07-20 |
| 1497080055 | Mohammed Jawad Latif | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401-6639 | 2009-10-14 |
| 1013995760 | Darryl Hoffman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St Ste 421, Bangor, ME 04401 | 2006-01-04 |
| 1528044245 | Robert Alan Clough | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St, Suite 421, Bangor, ME 04401-6630 | 2005-12-15 |
| 1912983636 | Felix Hernandez Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 State St, Suite 421, Bangor, ME 04401-6630 | 2005-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851692974 | Jeremy Richard Morton Sr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 75 Vaughan St, Portland, ME 04102-3641 | 2010-11-04 |
| 1750590915 | Elena M Ziarnik | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Campus Dr Unit 121, Scarborough, ME 04074-7172 | 2007-05-22 |
| 1174730238 | Appledore Mediacal Grp II, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12 Hospital Dr Ste A, York, ME 03909-1030 | 2007-05-17 |
| 1124233044 | Appledore Medical Grp II, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 16 Hospital Dr Ste 101, York, ME 03909-1041 | 2007-05-14 |
| 1104872050 | Desmond J. Donegan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 21 B Northbrook Drive, Maine Vein Center Associates, LLC, Falmouth, ME 04105-1379 | 2006-05-25 |
| 1689678112 | Gary M Hochheiser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2005-06-13 |
| 1841713633 | Jennifer Alice Kole | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 22 Bramhall St, Portland, ME 04102-3134 | 2017-07-24 |
| 1033377049 | John H Chaney | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 22 Bramhall St, Portland, ME 04102-3134 | 2008-05-27 |
| 1114113040 | Appledore Medical Group II Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12 Hospital Dr, Suite 9, York, ME 03909-1030 | 2007-09-25 |
| 1477752699 | Appledore Medical Group II Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12 Hospital Dr, Suite A, York, ME 03909-1030 | 2007-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.