MAINEHEALTH (NPI# 1346267879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346267879 |
| Entity Type | Organization |
| Organization Name | MAINEHEALTH |
| Other Organization Name | MMC FAMILY PRACTICE |
| Practice Address |
272 Congress St Portland ME 04101 |
| Mailing Address |
39 Wallace Ave Maine Medical Partners South Portland ME 04106-6143 |
| Practice Telephone | 2077610650 |
| Mailing Telephone | 2077610650 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | LUGENE ANTHONY INZANA (ASSOCIATE CFO) |
| Authorized Official Telephone | 2076623538 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 36236 | ME | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | ANTHEM BLUE CROSS PROV # | 200009000025 | 01 |
| ME | 102500000 | 05 |
| Other Name | Type Code |
|---|---|
| MMC Family Practice | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558841353 | Mainehealth | Skilled Nursing Facility | 35 July St, Sanford, ME 04073-1909 | 2018-08-21 |
| 1912304205 | Mainehealth | General Acute Care Hospital | 41 Spring Hill Rd, Saco, ME 04072-9650 | 2014-12-02 |
| 1831418128 | Mainehealth | Day Training, Developmentally Disabled Services | 39 Forest Ave, Portland, ME 04101 | 2010-05-26 |
| 1295800118 | Mainehealth | Clinic/Center | Cape Jellison Road, Stockton Springs, ME 04981 | 2006-11-24 |
| 1396815106 | Mainehealth | Pharmacy | Attn: Retail Pharmacy, 6 Glen Cove Drive, Rockport, ME 04856 | 2006-11-09 |
| 1528151065 | Mainehealth | Nursing Facility/Intermediate Care Facility | 145 Emery Lane, Boothbay Harbor, ME 04538 | 2006-10-02 |
| 1447342209 | Mainehealth | Skilled Nursing Facility | 35 July Street, Sanford, ME 04073 | 2006-09-29 |
| 1780788372 | Mainehealth | Internal Medicine | 19 West St, Portland, ME 04102 | 2006-09-12 |
| 1962496877 | Mainehealth | Skilled Nursing Facility | 6 White St, Rockland, ME 04841-2953 | 2005-09-07 |
| 1972129005 | Mainehealth | Clinic/Center | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2020-06-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAINEHEALTH SERVICES | 110 Free St, Portland, ME 04101-3908 |
| Colorado Business Entities | MaineHealth, Inc. | 22 Bramhall Street, Portland, ME 04102 |
| Street Address |
272 CONGRESS ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396739520 | William W Dexter | Family Medicine | 272 Congress St, Portland, ME 04102 | 2005-09-02 |
| 1063049062 | Kelly King | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-27 |
| 1841827003 | Samuel Poulin | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-26 |
| 1275160442 | Kathryn Anne Stefos | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-26 |
| 1841827169 | George Eyerer | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2020-03-25 |
| 1952754947 | Lindsey Clement | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2016-07-14 |
| 1467815274 | Marc Daniel Kimball | Student in an Organized Health Care Education/Training Program | 272 Congress St, Portland, ME 04101-3637 | 2016-03-30 |
| 1598153348 | Lisa Zummach | Social Worker | 272 Congress St, Portland, ME 04101-3637 | 2015-01-02 |
| 1609298447 | Chloe Farrell | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2014-01-14 |
| 1659616159 | Amy E Hinshaw | Nurse Practitioner | 272 Congress St, Portland, ME 04101-3637 | 2012-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447665526 | Linda Damaskos | General Acute Care Hospital | 310 Nw Upyown Terrace, 2a, Portland, OR 97210 | 2014-06-26 |
| 1093132946 | Mercy Hospital | General Acute Care Hospital | 175 Fore River Pkwy, Portland, ME 04102-2779 | 2014-03-27 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 1679879662 | Veterans Hospital | General Acute Care Hospital | 3710 S.w. U.S. Veterans Road, Portland, OR 97239-2964 | 2011-02-08 |
| 1083866933 | Providence St Vincent Hospital | General Acute Care Hospital | 1235 Ne 47th Ave, Suite 285, Portland, OR 97213-2100 | 2008-10-22 |
| 1205024387 | Vetrans Administration | General Acute Care Hospital | 6215 Ne Broadway St, Portland, OR 97213-4713 | 2007-10-14 |
| 1235337551 | Kalei Renae Kadau | General Acute Care Hospital | 1717 Sw Park Ave Apt 813, Portland, OR 97201-3240 | 2007-07-08 |
| 1134242506 | Portland Veterans Affairs Medical Center | General Acute Care Hospital | 5430 Sw Cameron Rd, Portland, OR 97221 | 2007-04-09 |
| 1487788147 | Portland Va Medical Center | General Acute Care Hospital | 5404 Sw Vermont St, Portland, OR 97219-1034 | 2007-03-15 |
| 1457436248 | Kathleen M Hamel | General Acute Care Hospital | 3710 Se Us Veterans Hospital Rd, Portland, OR 97207-9823 | 2006-10-27 |
| Find all providers in PORTLAND | ||||
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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.