DR. GREGORY BLAISDELL (NPI# 1689864233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689864233 |
| Entity Type | Individual |
| Full Name | DR. GREGORY BLAISDELL |
| Credential | MD |
| Practice Address |
335 Brighton Ave Suite 200 Portland ME 04102-2363 |
| Mailing Address |
301c Us Route 1 Scarborough ME 04074-9701 |
| Practice Telephone | 2076628600 |
| Practice Fax Number | 2076628668 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2015-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MD20727 | ME | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | 16000 | NH | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | ME112516 | FL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | ML20008868 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 3086827 | 05 | |
| FL | 1689864233 | 05 | |
| FL | CIGNA | PENDING | 01 |
| FL | AETNA | PENDING | 01 |
| FL | BC/BS | 14L3J | 01 |
| Street Address |
335 BRIGHTON AVE SUITE 200 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174515720 | Raymond R White | Orthopaedic Surgery | 335 Brighton Ave, Suite 200, Portland, ME 04103-2362 | 2005-08-19 |
| 1619519873 | Maine Medical Consultants PC | Internal Medicine | 335 Brighton Ave, Portland, ME 04102-2363 | 2019-10-09 |
| 1972085140 | Regina M Bowie | Registered Nurse | 335 Brighton Ave, Portland, ME 04102-2363 | 2018-09-04 |
| 1780170431 | Kayla Marlise Heins | Speech-Language Pathologist | 335 Brighton Ave, Portland, ME 04102-2363 | 2018-07-05 |
| 1700380466 | Katherine A Diconzo | Nurse Practitioner | 335 Brighton Ave, Portland, ME 04102 | 2018-03-19 |
| 1316471105 | Deborah Mcginnis | Occupational Therapist | 335 Brighton Ave, Portland, ME 04102-2363 | 2017-04-18 |
| 1811435100 | Andrew F Scichilone | Physician Assistant | 335 Brighton Ave, Suite 200, Portland, ME 04102-2363 | 2017-02-07 |
| 1134572316 | Physical and Functional Medicine Incorporated | Physical Medicine & Rehabilitation | 335 Brighton Ave, Portland, ME 04102-2363 | 2016-07-22 |
| 1710362421 | Joel P Miller | Physician Assistant | 335 Brighton Ave, Portland, ME 04102-2363 | 2015-07-23 |
| 1447646260 | Zachary Cohn | Student in an Organized Health Care Education/Training Program | 335 Brighton Ave, Portland, ME 04102-2363 | 2015-04-08 |
| Find all providers in the same location | ||||
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252272 | Venel Orthopaedic Institute At Lake Andrew | Orthopaedic Surgery | 10000 Se Main St Ste 205, Portland, OR 97216-2448 | 2018-04-18 |
| 1710382296 | Michael Baskin Md LLC | Orthopaedic Surgery | 4166 Sw Greenleaf Dr, Portland, OR 97221-3225 | 2014-10-27 |
| 1801132667 | Robert Andrew Berselli | Orthopaedic Surgery | 02113 Sw Military Rd, Portland, OR 97219-8428 | 2012-12-26 |
| 1134482284 | Andrew J Bryan | Orthopaedic Surgery | 1515 Nw 18th Ave Ste 300, Portland, OR 97209-2539 | 2012-06-22 |
| 1114297553 | Marc El Najjar | Orthopaedic Surgery | 1220 Sw 66th Ave # Appt2213, Portland, OR 97225-6022 | 2012-01-02 |
| 1245556984 | Penelope D Lang | Orthopaedic Surgery | 3500 N Interstate Ave, Kaiser Permanente, Interstate Medical Office South Orthopaedics, Portland, OR 97227-1196 | 2010-04-19 |
| 1154646453 | Ivanhoe B. Higgins, M.d., P.C. | Orthopaedic Surgery | 5050 Ne Hoyt St Ste 640, Portland, OR 97213-2990 | 2010-03-30 |
| 1811134836 | Robert Graf Mckillop | Orthopaedic Surgery | 21 Ne 7th Ave, Portland, OR 97232-2907 | 2009-01-13 |
| 1790920841 | Joseph Paul Schenck | Orthopaedic Surgery | 9925 Sw Quail Post Road, Portland, OR 97219 | 2008-12-03 |
| 1962680553 | Anthony Woodward | Orthopaedic Surgery | 10737 Sw Lancaster Rd, Portland, OR 97219-6494 | 2008-02-06 |
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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.