MAINEHEALTH (NPI# 1780788372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780788372 |
| Entity Type | Organization |
| Organization Name | MAINEHEALTH |
| Other Organization Name | MAINE TRANSPLANT PROGRAM |
| Practice Address |
19 West St Portland ME 04102 |
| Mailing Address |
301 Us Route 1 Building C Scarborough ME 04074-7609 |
| Practice Telephone | 2076627180 |
| Practice Fax Number | 2076627190 |
| Mailing Telephone | 2073968600 |
| Mailing Fax Number | 2073968632 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | LUGENE ANTHONY INZANA (SVP FINANCE/CFO) |
| Authorized Official Telephone | 2076623538 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30212545 | 05 | |
| ME | 102500201 | 05 |
| Other Name | Type Code |
|---|---|
| MAINE TRANSPLANT PROGRAM | 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 |
| 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 |
| 1902422561 | Mainehealth | Clinic/Center | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2020-06-19 |
| 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 |
19 WEST ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821413048 | Michele Creech | Dietitian, Registered | 19 West St, Portland, ME 04102-3405 | 2014-02-25 |
| 1154449759 | Deborah Ann Hoch | Nurse Practitioner | 19 West St, Portland, ME 04102-3405 | 2007-03-26 |
| 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 | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1184133746 | Abd Assalam Qannus | Internal Medicine | 22 Bramhall St Rm 5219, Portland, ME 04102-3134 | 2017-09-27 |
| 1023403748 | Sarah Gilligan | Internal Medicine | 19 Capisic St, Portland, ME 04102-2203 | 2015-03-31 |
| 1528487527 | Janie Luong | Internal Medicine | 10201 Se Main St Ste 27, Portland, OR 97216-2937 | 2014-04-08 |
| 1386074953 | David Alan Mccarron | Internal Medicine | 120 Nw 9th Ave, Suite 206, Portland, OR 97209-3324 | 2013-11-19 |
| 1578859849 | Thuy Xuan Le | Internal Medicine | 1040 Nw 22nd Ave Ste 480, Portland, OR 97210-3062 | 2011-06-24 |
| 1427348150 | Mark Nguyen | Internal Medicine | 1130 Nw 22nd Ave Ste 640, Portland, OR 97210-2993 | 2011-04-14 |
| 1720377039 | Robert Whitney Rope | Internal Medicine | 3181 Sw Sam Jackson Park Rd Mc Sjh6, Portland, OR 97239-3011 | 2011-04-07 |
| 1578707451 | Kate Schoolwerth Gustafson | Internal Medicine | 3710 Sw Us Veterans Hospital Rd # P3neph, Portland, OR 97239-2964 | 2009-04-23 |
| 1174777973 | Tricia Noelle Jesperson | Internal Medicine | 5050 Ne Hoyt St Ste B54, Portland, OR 97213 | 2008-11-06 |
| 1861677825 | Apolonia G. Silva | Internal Medicine | 6736 Ne Killingsworth Street La Clinica De Buena Salud, Portland, OR 97218-3338 | 2008-01-08 |
| 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.