MAINEHEALTH


Address: 100 Campus Dr, Unit 107, Scarborough, ME 04074
Phone: 2078857565

MAINEHEALTH (NPI# 1912204033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Maine Children's Cancer Program Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 100 CAMPUS DR
UNIT 107
City SCARBOROUGH
State ME
Zip Code 04074

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 2080P0207X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Hematology-Oncology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

Search similar providers

City SCARBOROUGH
Zip Code 04074

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Dataset Information

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.

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