MAINEHEALTH (NPI# 1457540486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457540486 |
| Entity Type | Organization |
| Organization Name | MAINEHEALTH |
| Other Organization Name | MMC PEDIATRIC UROLOGY |
| Practice Address |
22 Bramhall St Portland ME 04102 |
| Mailing Address |
301 Us Route 1 Building C Scarborough ME 04074-7609 |
| Practice Telephone | 2076622179 |
| Mailing Telephone | 2073968600 |
| Mailing Fax Number | 2073968632 |
| Enumeration Date | 2007-10-16 |
| 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 | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MMC Pediatric Urology | Doing Business As Name - 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 |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1285231217 | Malia Haddock | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-10-02 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891782868 | Patrick S O'hollaren | Urology | 9427 Sw Barnes Rd Ste 395, Portland, OR 97225-6652 | 2005-10-04 |
| 1942439005 | Casey Allison Seideman | Urology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2009-07-10 |
| 1962603175 | Daniel Aaron Hirselj | Urology | 2230 Nw Pettygrove St, Suite #210, Portland, OR 97210-2659 | 2007-05-29 |
| 1316972300 | David B Lashley | Urology | 2230 Nw Pettygrove, Suite 210, Portland, OR 97210 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710215751 | Maine Medical Partners | Urology | 100 Brickhill Ave, South Portland, ME 04106-1999 | 2009-12-03 |
| 1669665196 | David J Chalmers | Urology | 100 Brickhill Ave, South Portland, ME 04106-1999 | 2007-08-17 |
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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.