SPECTRUM MEDICAL GROUP, P.A. (NPI# 1639577620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639577620 |
| Entity Type | Organization |
| Organization Name | SPECTRUM MEDICAL GROUP, P.A. |
| Other Organization Name | NORTHERN RADIOLOGY ASSOCIATES OF MAINE |
| Practice Address |
489 State St Bangor ME 04401-6616 |
| Mailing Address |
Po Box 138 Lewiston ME 04243-0138 |
| Practice Telephone | 2074827800 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | DAVID LANDRY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2074827800 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECTRUM MEDICAL GROUP, P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Northern Radiology Associates of Maine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174050025 | Spectrum Medical Group, P.a. | Clinic/Center | 100 Griffin Rd, Portsmouth, NH 03801-7158 | 2017-05-22 |
| 1841722618 | Spectrum Medical Group, P.a. | Surgery | 10 Andover Rd, Portland, ME 04102-1954 | 2017-03-31 |
| 1003213208 | Spectrum Medical Group, P.a. | Anesthesiology | 489 State St, Bangor, ME 04401-6616 | 2014-12-03 |
| 1821495029 | Spectrum Medical Group, P.a. | Physical Medicine & Rehabilitation | 489 State St, Bangor, ME 04401-6616 | 2014-12-03 |
| 1801140660 | Spectrum Medical Group, P.a. | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2012-11-01 |
| 1265794655 | Spectrum Medical Group, P.a. | Physical Medicine & Rehabilitation | 77 Bates St, Suite 102, Lewiston, ME 04240-7637 | 2012-06-12 |
| 1588687586 | Spectrum Medical Group, P.a. | Radiology | 140 Academy St, Presque Isle, ME 04769-3102 | 2006-07-25 |
| Street Address |
489 STATE ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790789147 | Eastern Maine Medical Center | General Acute Care Hospital | 489 State St, Bangor, ME 04401-6616 | 2005-06-13 |
| 1356956239 | Amanda Roberts | Physician Assistant | 489 State St, Bangor, ME 04401-6674 | 2020-09-09 |
| 1558983148 | Lana Caroline Hoertz | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2020-05-18 |
| 1427696954 | Kelsey A Mcgrath | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-12-16 |
| 1528629888 | Jaclyn Young | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2019-06-26 |
| 1568928018 | Emily Bohm | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-20 |
| 1144786971 | Andrew Hopkins | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-18 |
| 1750847083 | Daniel Patrick Conway | Physician Assistant | 489 State St, Bangor, ME 04401-6616 | 2019-02-12 |
| 1306317847 | Matthew Daniel Kent | Nurse Anesthetist, Certified Registered | 489 State St, Bangor, ME 04401-6616 | 2018-12-10 |
| 1750869061 | Brian Marsh | Nurse Practitioner | 489 State St, Bangor, ME 04401 | 2018-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922655562 | Insight-premier Health LLC | Radiology | 489 State St Ste 100, Bangor, ME 04401-6616 | 2019-08-19 |
| 1366840340 | Spectrum Healthcare Partners, P.a. | Radiology | 489 State St, Bangor, ME 04401-6616 | 2014-12-08 |
| 1285078121 | Hussain Ali H Al Khalifah | Radiology | 489 State St, Bangor, ME 04401-6616 | 2013-04-22 |
| 1437592995 | Vasavi Paidpally | Radiology | 489 State St, Bangor, ME 04401-6616 | 2013-04-15 |
| 1578827044 | Hamza Jawad | Radiology | 489 State St, Bangor, ME 04401-6616 | 2012-06-29 |
| 1306135561 | Gurpreet Singh Sandhu | Radiology | 489 State St, Bangor, ME 04401-6616 | 2011-03-28 |
| 1285950725 | Yeang Howe Chng | Radiology | 489 State St, Bangor, ME 04401-6616 | 2010-04-08 |
| 1396904280 | Iftikhar Ahmad | Radiology | 489 State St, Bangor, ME 04401-6616 | 2008-06-05 |
| 1639369150 | Justin J Levine | Radiology | 489 State St, Bangor, ME 04401-6616 | 2007-07-31 |
| 1629299003 | Edward P. Nicholas | Radiology | 489 State St, Bangor, ME 04401-6616 | 2007-05-01 |
| Find all providers in BANGOR | ||||
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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.