PORTLAND FOOT & ANKLE, PA (NPI# 1417952318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417952318 |
Entity Type | Organization |
Organization Name | PORTLAND FOOT & ANKLE, PA |
Practice Address |
68 Marginal Way 4th Floor Portland ME 04101 |
Practice Telephone | 2078791339 |
Practice Fax Number | 2078791092 |
Mailing Telephone | 2078791339 |
Mailing Fax Number | 2078791092 |
Enumeration Date | 2005-06-16 |
Last Update Date | 2014-03-20 |
Authorized Official Name | MR. ROBERT SCOTT JURIS (PHYSICIAN/OWNER) |
Authorized Official Telephone | 2078791339 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ME | ROBERT S. JURIS | 480023694 | 01 |
ME | RAILROAD MEDICARE GROUP | CH4448 | 01 |
ME | K. PAUL FLANIGAN | 480030888 | 01 |
ME | DMERC GROUP | 0619920001 | 01 |
ME | PALMETTO GROUP | CH4448 | 01 |
Street Address |
68 MARGINAL WAY 4TH FLOOR |
City | PORTLAND |
State | ME |
Zip Code | 04101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710125596 | Kenneth Maisak | Podiatrist | 68 Marginal Way, Portland, ME 04101-2444 | 2009-02-02 |
1780650408 | Robert S Juris | Podiatrist | 68 Marginal Way, 4th Fllor, Portland, ME 04101-2444 | 2006-02-23 |
1881669836 | Danforth S Desena | Podiatrist | 68 Marginal Way, 4th Floor, Portland, ME 04101-2444 | 2006-02-22 |
1780659722 | Kenneth Paul Flanigan IIi | Podiatrist | 68 Marginal Way, 4th Floor, Portland, ME 04101-2444 | 2006-02-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
Find all providers in zip 04101 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386051803 | Southwest Podiatry Center LLC | Podiatrist | 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 | 2014-07-16 |
1386884237 | Lopa Dalmia | Podiatrist | 12400 Nw Cornell Rd Ste 201, Portland, OR 97229-5689 | 2009-03-04 |
1679743876 | Brandi S. Myers Dpm, LLC | Podiatrist | 7836 Se 13th Ave, Portland, OR 97202-6350 | 2008-03-04 |
1093921975 | Brian M. Bowen | Podiatrist | 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1569 | 2007-05-15 |
1689700486 | Brandi Sue Myers | Podiatrist | 5225 Se 28th Ave, Portland, OR 97202-4506 | 2007-02-26 |
1255440020 | Gina M Bullock | Podiatrist | 3508 Ne Broadway St, Portland, OR 97232-1821 | 2006-08-29 |
1982647467 | Thomas R Palmer | Podiatrist | 6108 Ne Glisan St, Portland, OR 97213-3864 | 2006-06-13 |
1962454934 | Clifford Donald Mah | Podiatrist | 12400 Nw Cornell Rd, Suite 201, Portland, OR 97229-5693 | 2006-05-17 |
1538149471 | Christopher Gerard Pingitore | Podiatrist | 51 Sewall St Ste 2, Portland, ME 04102-2644 | 2006-01-18 |
1194705038 | John Henry Dorsey Jr. | Podiatrist | 195 Fore River Parkway, Suite 120, Portland, ME 04102 | 2006-01-18 |
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.