MAINEHEALTH (NPI# 1912204033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912204033 |
Entity Type | Organization |
Organization Name | MAINEHEALTH |
Other Organization Name | MAINE CHILDREN'S CANCER PROGRAM |
Practice Address |
100 Campus Dr Unit 107 Scarborough ME 04074 |
Mailing Address |
22 Bramhall St Portland ME 04102-3134 |
Practice Telephone | 2078857565 |
Practice Fax Number | 2078857577 |
Mailing Telephone | 2076626562 |
Enumeration Date | 2011-02-25 |
Last Update Date | 2020-05-11 |
Authorized Official Name | LUGENE ANTHONY INZANA (ASSOCIATE CFO) |
Authorized Official Telephone | 2076623538 |
Is Organization Subpart | Y |
Parent Organization Name | MAINE MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 282N00000X | General Acute Care Hospital | 37563 | ME | Hospitals |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Maine Children's Cancer Program | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558841353 | Mainehealth | Skilled Nursing Facility | 35 July St, Sanford, ME 04073-1909 | 2018-08-21 |
1912304205 | Mainehealth | General Acute Care Hospital | 41 Spring Hill Rd, Saco, ME 04072-9650 | 2014-12-02 |
1831418128 | Mainehealth | Day Training, Developmentally Disabled Services | 39 Forest Ave, Portland, ME 04101 | 2010-05-26 |
1295800118 | Mainehealth | Clinic/Center | Cape Jellison Road, Stockton Springs, ME 04981 | 2006-11-24 |
1396815106 | Mainehealth | Pharmacy | Attn: Retail Pharmacy, 6 Glen Cove Drive, Rockport, ME 04856 | 2006-11-09 |
1528151065 | Mainehealth | Nursing Facility/Intermediate Care Facility | 145 Emery Lane, Boothbay Harbor, ME 04538 | 2006-10-02 |
1447342209 | Mainehealth | Skilled Nursing Facility | 35 July Street, Sanford, ME 04073 | 2006-09-29 |
1780788372 | Mainehealth | Internal Medicine | 19 West St, Portland, ME 04102 | 2006-09-12 |
1962496877 | Mainehealth | Skilled Nursing Facility | 6 White St, Rockland, ME 04841-2953 | 2005-09-07 |
1972129005 | Mainehealth | Clinic/Center | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2020-06-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MAINEHEALTH SERVICES | 110 Free St, Portland, ME 04101-3908 |
Colorado Business Entities | MaineHealth, Inc. | 22 Bramhall Street, Portland, ME 04102 |
Street Address |
100 CAMPUS DR UNIT 107 |
City | SCARBOROUGH |
State | ME |
Zip Code | 04074 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689678112 | Gary M Hochheiser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2005-06-13 |
1720525447 | Theresa Roelke | Nurse Practitioner | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2017-01-20 |
1083162481 | Kathlene Gravelin | Genetic Counselor, MS | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2016-09-14 |
1851781710 | Katherine Anne Lafferty | Genetic Counselor, MS | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2015-01-30 |
1700276581 | Amanda Lamb | Genetic Counselor, MS | 100 Campus Dr, Suite #121, Scarborough, ME 04074-7171 | 2015-01-30 |
1073803144 | Summer D Mowry | Nurse Practitioner | 100 Campus Dr, Suite 108, Scarborough, ME 04074-7171 | 2011-04-11 |
1841596517 | Mainehealth | Internal Medicine | 100 Campus Dr, Suite 110, Scarborough, ME 04074 | 2011-01-28 |
1053647024 | Mainehealth | General Acute Care Hospital | 100 Campus Dr, Unit 103, Scarborough, ME 04074-7171 | 2009-10-27 |
1588801773 | Karen Anne Phelps | Nurse Practitioner | 100 Campus Dr, Suite 121, Scarborough, ME 04074-7171 | 2009-01-10 |
1962668863 | Jessica H Cary | Genetic Counselor, MS | 100 Campus Dr, Unit 108, Scarborough, ME 04074-7171 | 2008-07-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407462443 | Jennifer Marlowe | Counselor | Crossroads Maine 71-us-1, Scarborough, ME 04074 | 2020-09-16 |
1508475724 | Whole Medicine LLC | Family Medicine | 2o Mussey Road, Suite 2, Scarborough, ME 04074 | 2020-07-23 |
1154957793 | Maria Robin Libby | Occupational Therapist | 144 Us-1 #4, Scarborough, ME 04074 | 2020-03-16 |
1558902932 | Daphne Berta Counseling P.C. | Counselor | 636 Route 1, Scarborough, ME 04074 | 2019-10-07 |
1619450574 | Louise Valati | Physical Therapist | Piper Shores, 15 Piper Road, Scarborough, ME 04074 | 2018-09-07 |
1770001315 | Emily Dunuwila | Massage Therapist | 51 Us Route One Suite R2, Scarborough, ME 04074 | 2017-09-04 |
1750808788 | Jill Daicey Hutchison | Physical Therapy Assistant | 67 Pine Point Road, Scarborough, ME 04074 | 2017-08-30 |
1457887580 | Rebecca Shaw | Social Worker | 119 Ash Swamp Road, Scarborough, ME 04074 | 2017-05-10 |
1184168767 | Jessica Ann Kaake | Occupational Therapist | 308 Us Route 1 Ste E1, Scarborough, ME 04074 | 2016-12-15 |
1356895056 | Nancy Gaudet | Counselor | 6 Catherine Drive, Scarborough, ME 04074 | 2016-08-10 |
Find all providers in zip 04074 |
Taxonomy Code | 2080P0207X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Hematology-Oncology |
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013945708 | Aaron R Weiss | Pediatrics | 100 Campus Drive, Unit 107, Scarborough, ME 04074-9692 | 2006-06-29 |
1871549451 | Stanley Chaleff | Pediatrics | 100 Campus Dr, Unit 107, Scarborough, ME 04074-9692 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992913255 | Stephen Blattner | Pediatrics | 17 Cole Field Rd, Cape Elizabeth, ME 04107-9676 | 2007-05-18 |
1528334406 | Chittalsinh M. Raulji | Pediatrics | 33 Whiting Hill Rd, Suite 31, Brewer, ME 04412-1021 | 2012-03-26 |
1760757868 | Subha Mazzone | Pediatrics | 33 Whiting Hill Rd, Suite 31, Brewer, ME 04412 | 2012-03-21 |
1134428899 | Daniel Lee Callaway | Pediatrics | 33 Whiting Hill Rd, Brewer, ME 04412-1021 | 2011-03-21 |
1366548935 | Sarah J Fryberger | Pediatrics | 33 Whiting Hill Rd, Suite 31, Brewer, ME 04412-1021 | 2006-09-14 |
1780617175 | Hassan Dannawi | Pediatrics | 489 State St, Bangor, ME 04401-6616 | 2006-07-08 |
1497782767 | Judith B Allen | Pediatrics | 489 State St, Bangor, ME 04401-6616 | 2006-06-26 |
City | SCARBOROUGH |
Zip Code | 04074 |
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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.