PORTLAND ENDOSCOPY CENTER (NPI# 1558456459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558456459 |
Entity Type | Organization |
Organization Name | PORTLAND ENDOSCOPY CENTER |
Practice Address |
161 Marginal Way Portland ME 04101-2438 |
Practice Telephone | 2077737964 |
Practice Fax Number | 2077739073 |
Mailing Telephone | 2077737964 |
Mailing Fax Number | 2077739073 |
Enumeration Date | 2006-10-04 |
Last Update Date | 2019-12-23 |
Authorized Official Name | MELISSA GOUSSE (PRACTICE ADMINISTRATOR) |
Authorized Official Telephone | 2077737964 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ME | 118790000 | 05 | |
NH | 30621368 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
1200 Congress St Ste 300, Portland, ME 041022168 | 2077737964 | 2077739073 |
Street Address |
161 MARGINAL WAY |
City | PORTLAND |
State | ME |
Zip Code | 04101-2438 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518963677 | Jeffrey K Moore | Ophthalmology | 161 Marginal Way, Portland, ME 04101-2438 | 2005-06-23 |
1477952075 | Karen Stoughton | Nurse Practitioner | 161 Marginal Way, Portland, ME 04101-2438 | 2014-08-19 |
1376950337 | Ekaterina Funk | Nurse Practitioner | 161 Marginal Way, Portland, ME 04101-2438 | 2014-07-22 |
1831534031 | Cristina Churchill Rutherford | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2013-05-02 |
1376986513 | Kelly Daylyn Pizzo | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2013-04-08 |
1164710075 | Noemi Baffy | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2011-07-12 |
1831488477 | Karrie K Sweet | Dietitian, Registered | 161 Marginal Way, Portland, ME 04101 | 2011-04-05 |
1033363528 | Caitlin Phelps | Physician Assistant | 161 Marginal Way, Portland, ME 04101-2438 | 2008-11-10 |
1134325806 | Kate Forssell Kennedy | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2007-06-21 |
1891990602 | Daniil Rolshud | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2007-06-20 |
Find all providers in the same location |
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 | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
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1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
1780959007 | Columbia River Surgery Center LLC | Clinic/Center | 9820 Ne Cascades Pkwy, Portland, OR 97220-6825 | 2012-03-20 |
1245471788 | Pacific Cataract and Laser Institute Inc PC | Clinic/Center | 1331 Nw Lovejoy Street, Suite 750, Portland, OR 97209 | 2009-03-12 |
1518022615 | Futures Outpatient Surgical Center | Clinic/Center | 1849 Nw Kearney St Ste 302, Portland, OR 97209-1453 | 2006-12-27 |
1245336411 | Lovejoy Surgicenter Inc. | Clinic/Center | 933 Nw 25th Ave, Portland, OR 97210-2829 | 2006-09-15 |
1710992680 | Ambulatory Surgical Center | Clinic/Center | 10201 Se Main St Ste 20, Portland, OR 97216-2937 | 2006-07-29 |
1609896539 | Cedar Hills Ambulatory Surgery Center LLC | Clinic/Center | 10305 Sw Park Way Ste 101, Portland, OR 97225-5033 | 2006-07-21 |
1376599381 | Eyecare Medical Group | Clinic/Center | 53 Sewall Street, Portland, ME 04102-2625 | 2006-05-25 |
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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.