CASCO BAY GASTROENTEROLOGY LLC (NPI# 1972579241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972579241 |
| Entity Type | Organization |
| Organization Name | CASCO BAY GASTROENTEROLOGY LLC |
| Practice Address |
25 Long Creek Dr South Portland ME 04106-2440 |
| Practice Telephone | 2078790094 |
| Practice Fax Number | 2078790095 |
| Mailing Telephone | 2078790094 |
| Mailing Fax Number | 2078790095 |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | CHRISTINE MARIE DAIGLE (BILLING MANAGER) |
| Authorized Official Telephone | 2078790094 |
| Authorized Official Credential | CCP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | RAILROAD MEDICARE | DC0798 | 01 |
| ME | 126510000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619138401 | Casco Bay Gastroenterology LLC | Internal Medicine | 195 Fore River Pkwy Ste 490, Portland, ME 04102-2779 | 2008-06-24 |
| Street Address |
25 LONG CREEK DR |
| City | SOUTH PORTLAND |
| State | ME |
| Zip Code | 04106-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679543219 | Jaime Hare | Nurse Practitioner | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2006-01-25 |
| 1073704029 | Pamela Ryder Fox | Nurse Practitioner | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-08-06 |
| 1861690471 | Christopher Scott Kleeman | Internal Medicine | 25 Long Creek Dr, South Portland, ME 04106-2449 | 2007-07-05 |
| 1124232772 | W. David Melevsky, Dds | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-05-10 |
| 1336361484 | David S Palmer, Dmd, Pa | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-05-02 |
| 1588781405 | Michael T. Ruetty Dds, LLC | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-03-24 |
| 1154469740 | Michael Thomas Ruetty | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-02-03 |
| 1124170709 | Walter David Melevsky | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2007-01-17 |
| 1760592042 | Linda C Livingston | Nurse Anesthetist, Certified Registered | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2006-08-30 |
| 1548292725 | Jean Paul Boudreau | Dentist | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513748 | Rayna Louise Sage | Behavior Technician | 50 Donald Beaver Drrive, Ste B, Portland, ME 04106 | 2020-09-17 |
| 1972127330 | Scott M Davis Md LLC | Internal Medicine | 89 Cannon Road, South Portland, ME 04106 | 2020-06-02 |
| 1568013936 | Clara Cassidy | Behavior Technician | 50 Donald Bean Dr, Ste B, South Portland, ME 04106 | 2019-09-26 |
| 1336614346 | Kari Whitney | Nurse Practitioner | Vna Home Health Hospice, 50 Foden Road, Suite 1, South Portland, ME 04106 | 2018-10-05 |
| 1588152193 | Kristen F. Pierce | Counselor | 100 Waterman Drive, Suite 201, South Portland, ME 04106 | 2018-04-30 |
| 1649779224 | Jennifer Rene Johnson | Social Worker | 135 Westbrook St, South Portland, ME 04106 | 2018-02-08 |
| 1154847721 | Integral Nutrition, LLC | Dietitian, Registered | 59 Baltimore Avenue, South Portland, ME 04106 | 2017-08-16 |
| 1730619610 | John Preston Powell | Psychiatry & Neurology | 68 B Street Apt 4, South Portland, ME 04106 | 2017-06-14 |
| 1649706268 | Gisselle Mani | Student in an Organized Health Care Education/Training Program | 30 Lydia Ln Apt 2115, South Portland, ME 04106 | 2017-05-02 |
| 1245786987 | Jonathan Frank Olmes | Optometrist | 335 Maine Mall Rd., South Portland, ME 04106 | 2016-09-01 |
| Find all providers in zip 04106 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1053712984 | Philip G. Hunter | Internal Medicine | 34 Pine Ledge Rd, Bangor, ME 04401-2031 | 2014-09-10 |
| 1619138401 | Casco Bay Gastroenterology LLC | Internal Medicine | 195 Fore River Pkwy Ste 490, Portland, ME 04102-2779 | 2008-06-24 |
| 1033314620 | Mira Regina Olson | Internal Medicine | 700 Mount Hope Ave Ste 430, Bangor, ME 04401 | 2007-06-15 |
| 1699983536 | Gastroenterology Associates of Eastern Maine | Internal Medicine | 210 Evergreen Woods, Bangor, ME 04401-5655 | 2007-05-21 |
| 1407060429 | Gary Weaver | Internal Medicine | 287 Long Point Rd, Harpswell, ME 04079-3907 | 2007-05-09 |
| 1356569529 | Newell A Augur Jr. | Internal Medicine | 16 Chadwick St, Portland, ME 04102-3504 | 2007-04-23 |
| 1487712733 | Southern Maine Gastroenterology, LLC | Internal Medicine | 10 Storer St Unit 106, Lafayette Center, Kennebunk, ME 04043 | 2006-12-05 |
| 1093804882 | David William Hay | Internal Medicine | 325 E Kennedy Memorial Drive, Mainegeneral Gastroenterology, Waterville, ME 04901 | 2006-10-12 |
| 1235222043 | Phillip B Amidon | Internal Medicine | 417 State Street, Suite 121, Gastroenterology Center of Maine, Bangor, ME 04401 | 2006-10-02 |
| 1134131675 | William Gordon Silber | Internal Medicine | 11 Martin St, Presque Isle, ME 04769-2238 | 2006-08-13 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH PORTLAND |
| Zip Code | 04106 |
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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.