CASCO BAY GASTROENTEROLOGY LLC (NPI# 1619138401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619138401 |
| Entity Type | Organization |
| Organization Name | CASCO BAY GASTROENTEROLOGY LLC |
| Practice Address |
195 Fore River Pkwy Ste 490 Portland ME 04102-2779 |
| Mailing Address |
25 Long Creek Dr South Portland ME 04106-2440 |
| Practice Telephone | 2079999999 |
| Mailing Telephone | 2078790094 |
| Mailing Fax Number | 2078790095 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | CHRISTINE MARIE DAIGLE (BILLING/CREDENTIALING MANAGER) |
| Authorized Official Telephone | 2078798989 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972579241 | Casco Bay Gastroenterology LLC | Internal Medicine | 25 Long Creek Dr, South Portland, ME 04106-2440 | 2006-02-27 |
| Street Address |
195 FORE RIVER PKWY STE 490 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2779 |
| 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 | 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 |
|---|---|---|---|---|
| 1003175464 | Arnab Mitra | Internal Medicine | 3181 Sw Sam Jackson Park Road, L461, Oregon Health and Science University, Portland, OR 97239-3098 | 2012-05-04 |
| 1154584241 | Dana N Hemmati | Internal Medicine | 10000 Se Main St Ste 112, Portland, OR 97216-2441 | 2008-07-08 |
| 1750587945 | Charles Clark Gabbert II | Internal Medicine | 1111 Ne 99th Ave Ste 301, Portland, OR 97220-9442 | 2007-06-25 |
| 1457556086 | Marc Karl Binder | Internal Medicine | 1125 Nw 9th Ave, #431, Portland, OR 97209-2864 | 2007-06-14 |
| 1356569529 | Newell A Augur Jr. | Internal Medicine | 16 Chadwick St, Portland, ME 04102-3504 | 2007-04-23 |
| 1326117771 | John Lee Haughom | Internal Medicine | 0841 Sw Gaines St Unit 2204, Portland, OR 97239-3105 | 2006-11-07 |
| 1356431464 | Hsichao Chow | Internal Medicine | 10000 Se Main St 112, Gastroenterology Assoc, Portland, OR 97216-2441 | 2006-10-13 |
| 1356356851 | Kandice Leigh Knigge | Internal Medicine | 3181 Sw Sam Jackson Park Rd # 310, Portland, OR 97239-3011 | 2006-07-31 |
| 1841290699 | Ronald J. Hapke | Internal Medicine | 1130 Nw 22nd Ave Ste 410, Portland, OR 97210-2911 | 2005-07-22 |
| 1831534031 | Cristina Churchill Rutherford | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2013-05-02 |
| 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.