DR. KURT S EBRAHIM (NPI# 1386615201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386615201 |
| Entity Type | Individual |
| Full Name | DR. KURT S EBRAHIM |
| Credential | D.O. |
| Practice Address |
2 Independence Dr Kennebunk ME 04043-6078 |
| Mailing Address |
P.o. Box 911 Brattleboro VT 05302 |
| Practice Telephone | 2079850008 |
| Practice Fax Number | 2079859820 |
| Mailing Telephone | 2073967600 |
| Mailing Fax Number | 2073968381 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2018-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
1271 | ME | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
1271 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | RR MEDICARE | 900001630 | 01 |
| ME | ANTHEM BLUE SHIELD | 018305 | 01 |
| ME | MAINE LICENSE | 1271 | 01 |
| ME | NH MEDICAID | 30200551 | 01 |
| ME | AETNA | 5470239 | 01 |
| ME | AETNA HMO | 1041691 | 01 |
| ME | CIGNA | 4778555 | 01 |
| ME | 224040099 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 51 Us Route 1 Ste I, Scarborough, ME 040747145 | 2073033300 | 2073033016 |
| 100 Campus Dr Unit 108, Scarborough, ME 040747172 | 2073033300 | 2073967610 |
| 105 Topsham Fair Mall Rd Unit 1, Topsham, ME 040861773 | 2077291148 | 2077292789 |
| Street Address |
2 INDEPENDENCE DR |
| City | KENNEBUNK |
| State | ME |
| Zip Code | 04043-6078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205376274 | Maine Center for Cancer Medicine & Blood Disorders, P.a. | Durable Medical Equipment & Medical Supplies | 2 Independence Dr, Kennebunk, ME 04043-6078 | 2017-02-24 |
| 1366631384 | Melanie E Cogan | Nurse Practitioner | 2 Independence Dr, Kennebunk, ME 04043-6078 | 2007-10-16 |
| 1104953546 | Jamie E. Mckenzie | Internal Medicine | 2 Independence Dr, Kennebunk, ME 04043 | 2007-02-27 |
| 1770625410 | Can Ilyas | Internal Medicine | 2 Independence Dr, Kennebunk, ME 04043-6078 | 2007-02-12 |
| 1801846563 | Bridget R Franciose | Nurse Practitioner | 2 Independence Dr, Kennebunk, ME 04043-6078 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295397032 | Savida Agency, Inc. | Psychiatry & Neurology | 21a Western Ave, Suite 1, Kennebunk, ME 04043 | 2019-07-02 |
| 1578018610 | Christine Fecko | Social Worker | 14 Summer Street, Kennebunk, ME 04043 | 2016-08-18 |
| 1861841785 | Sarah Pollack | Pharmacist | 18 Blue Wave Professional Center, Kennebunk, ME 04043 | 2016-06-10 |
| 1417305566 | You&me Psychological and Consultation Services (ypcs) | Psychologist | Room 201, 8-7, Yanghwaro 12gil, Mapo-gu, Seoul, KOREA 04043 | 2016-05-31 |
| 1679933972 | Kimberly Kasten | Physician Assistant | 2 Livewell Drive, South Tower, Suite 200, Kennebunk, ME 04043 | 2016-02-29 |
| 1033592837 | Rachel Lawson Orr | Clinical Neuropsychologist | Southern Maine Health Care Pediatrics, 3 Shape Drive, Kennebunk, ME 04043 | 2015-06-30 |
| 1447649280 | Mark Ouellette | Nurse Practitioner | 2 Livewell Drive - North Tower, Kennebunk, ME 04043 | 2015-01-16 |
| 1902155005 | Kristina Caron Occupational Therapy, LLC | Occupational Therapist | 27 Fletcher St Apt 2, Kennebunk, ME 04043 | 2012-09-05 |
| 1174838361 | Tracy Lynn Mason | Occupational Therapist | 87 Fletcher St., Maine Regional School Unit 21, Kennebunk, ME 04043 | 2010-08-11 |
| 1538392261 | Susanne Randall | In Home Supportive Care | 3 Elannas Way, Kennebunk, ME 04043 | 2009-08-28 |
| Find all providers in zip 04043 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104953546 | Jamie E. Mckenzie | Internal Medicine | 2 Independence Dr, Kennebunk, ME 04043 | 2007-02-27 |
| 1770625410 | Can Ilyas | Internal Medicine | 2 Independence Dr, Kennebunk, ME 04043-6078 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518131168 | Rodrigo Otavio Boff Maegawa | Internal Medicine | 33 Whiting Hill Road, Eastern Maine Medical Center, Brewer, ME 04412-1004 | 2008-04-15 |
| 1285830554 | Brian Roger Haney | Internal Medicine | 105 Topsham Fair Mall Rd Unit 1, Topsham, ME 04086 | 2007-06-25 |
| 1295755635 | Astrid C Andreescu | Internal Medicine | 33 Whiting Hill Rd Ste 21, Brewer, ME 04412-1022 | 2006-07-20 |
| 1720025588 | Charles K Tashima | Internal Medicine | 329 Maine Street, Brunswick, ME 04011 | 2006-06-01 |
| 1932165990 | Mainegeneral Health Associates Dba Oncology Associates | Internal Medicine | Oncology Associates, 149 North St, Waterville, ME 04901 | 2006-04-26 |
| 1205896107 | Maine Center for Cancer Medicine & Blood Disorders, P.a. | Internal Medicine | 100 Campus Dr Unit 108, Scarborough, ME 04074-7172 | 2006-03-24 |
| 1477524387 | Preston H Dalglish Jr. | Internal Medicine | 26 W Cole Rd, Biddeford, ME 04005-9407 | 2006-01-30 |
| 1487651584 | Christian Anton Thomas | Internal Medicine | 100 Campus Drive, Suite 108, Scarborough, ME 04074 | 2005-07-05 |
| 1205838570 | David Clark Caldwell | Internal Medicine | 12 High St, Ste 205, Lewiston, ME 04240-7676 | 2005-06-01 |
| 1457760340 | Sriman Swarup | Internal Medicine | 33 Whiting Hill Rd, Brewer, ME 04412-1021 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
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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.