MAINEHEALTH (NPI# 1699076133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699076133 |
| Entity Type | Organization |
| Organization Name | MAINEHEALTH |
| Other Organization Name | MMC DIABETES CONSULT SERVICE |
| Practice Address |
22 Bramhall St Portland ME 04102 |
| Mailing Address |
301 Us Route 1 Building C Scarborough ME 04074-7609 |
| Practice Telephone | 2076622651 |
| Mailing Telephone | 2073968600 |
| Mailing Fax Number | 2073968632 |
| Enumeration Date | 2010-11-16 |
| 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 | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MMC Diabetes Consult Service | 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 | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669731204 | Elena Vladimirovna Varlamov | Internal Medicine | 3181 Sw Sam Jackson Park Road, L607, Portland, OR 97239-3098 | 2012-05-15 |
| 1134486780 | Leah M Wilson | Internal Medicine | 3181 Sw Sam Jackson Park Rd L579, Ohsu, Portland, OR 97239 | 2012-04-20 |
| 1700983574 | Maria Fleseriu | Internal Medicine | 3181 Sw Sam Jackson Park Rd # Bte472, Portland, OR 97239-3011 | 2006-09-20 |
| 1437138955 | Wesley P Fairfield | Internal Medicine | 144 State St Fl 4, Portland, ME 04101-3776 | 2006-01-12 |
| 1811985963 | David Rawson Hotelling | Internal Medicine | 477 Congress St, 5th Floor, Portland, ME 04101-3427 | 2005-10-12 |
| 1942795539 | Teresa Anne Hillier Graham | Internal Medicine | 3800 N Interstate Ave, Portland, OR 97227-1110 | 2018-06-26 |
| 1982067351 | Shao Ting Dawn Lim | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2016-04-01 |
| 1497044614 | Sarah Soltman | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2011-03-29 |
| 1871892653 | Sarah Hopkins | Internal Medicine | 5050 Ne Hoyt St, Suite 540, Portland, OR 97213-2991 | 2011-03-20 |
| 1588836654 | Karen Jacobson | Internal Medicine | 9135 Sw Barnes Rd Ste 985, Portland, OR 97225-6699 | 2008-03-29 |
| 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.