Active NPI
Mainehealth
Doing business as MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)
- Orthopaedic Trauma Physician
- Portland, ME
National Provider Identifier
1003113127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Trauma Physician
- Legal business name
- MAINEHEALTH
- Doing business as
- MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)
- Practice address
- 335 Brighton Ave
Suite 200
Portland, ME 04102-2363 - Phone
- (207) 662-8600
- Fax
- (207) 662-8668
- NPI assigned
- Feb 25, 2011
- Last updated
- May 11, 2020
- Organization subpart
- Yes
- Parent organization
- MAINEHEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lugene Anthony Inzana
- Title
- Associate Cfo
- Phone
- (207) 662-3538
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 37563 | ME | |
| Surgical Physician Assistant | 363AS0400X | NU | ||
| Orthopaedic Trauma Physician | 207XX0801X | NU | Primary |
Addresses
Primary practice location
335 Brighton Ave
Suite 200
Portland, ME 04102-2363
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-6562
Other names 1
- MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000351 | ME | Part B Supplier - Clinic/Group Practice | 7517860588 |
Receives reassigned benefits from 46 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Farmington, ME; Portland, ME; Scarborough, ME |
| O20071116000569 | ME | Part A Provider - Hospital | 7517860588 |
35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1003113127. Details of each certification follow.
Hospital certification: CCN 200009
- Legal name
- MAINEHEALTH
- Doing business as
- MAINEHEALTH MAINE MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Feb 27, 2019
- Beds
- 606
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Enrollment address
- 22 Bramhall St
Portland, ME 41023134 - Hospital subgroups
- General, Acute care
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs on the same Medicare enrollment 38
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Maine Hemophilia and Thrombosis Center
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
O20071116000569
-
dba Maine Medical Center Infectious Disease
- Infectious Disease Physician
- Portland, ME
- NPI 1073701157
O20040331000351, O20071116000569
-
dba MMC Oral Surgery
- Oral & Maxillofacial Surgery (D.M.D.)
- Portland, ME
- NPI 1073702288
O20040331000351
-
dba Geriatric Consults
- Geriatric Medicine (Internal Medicine) Physician
- Portland, ME
- NPI 1164610242
O20040331000351, O20071116000569
-
dba MMC Pediatric Intensive Care Unit
- Pediatric Critical Care Medicine Physician
- Portland, ME
- NPI 1265536817
O20040331000351, O20071116000569
-
dba MMC Cardiology
- Cardiovascular Disease Physician
- Portland, ME
- NPI 1346428745
O20040331000351
-
dba Maine Medical Partners Endocrinlogy & Diabetes
- Endocrinology, Diabetes & Metabolism Physician
- Scarborough, ME
- NPI 1356651038
O20071116000569
-
dba MMC Pediatric Urology
- Pediatric Urology Physician
- Portland, ME
- NPI 1457540486
O20040331000351, O20071116000569
Care Compare: Hospital
Medicare Care Compare- Listed as
- Mainehealth Maine Medical Center
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Part of
- Maine Medical Assoc
Interoperability endpoints
- https://fhir.mainehealth.org/FHIRPRD/api/FHIR/R4/
Ownership & related parties
All disclosed owners & managing parties 33
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nancy a Hasenfus | Corporate Director | Jan 1, 2019 | |
| Brett Loffredo | Corporate Director | Jan 1, 2019 | |
| Brian H Noyes | Corporate Director | Oct 1, 2016 | |
| Dawn M Tutt | W-2 Managing Employee | Dec 30, 2013 | |
| Marie J McCarthy | Corporate Director | Oct 1, 2016 | |
| Matthew Chin | Corporate Director | Apr 1, 2025 | |
| Katherine B Coster | Corporate Director | Oct 1, 2016 | |
| Beth Kelsch | Corporate Officer | Apr 1, 2025 | |
| Robert Hunter | Corporate Officer | Dec 1, 2025 | |
| Ann W Bresnahan | Corporate Director | Oct 1, 2023 | |
| Christopher Cimino | Corporate Director | Oct 1, 2025 | |
| Andrew T Mueller | Corporate Officer | Jul 1, 2021 | |
| Lisa T Beaule | Corporate Director | Jan 1, 2019 | |
| Charles Richard Bayman | Corporate Officer | Dec 1, 2025 | |
| Corporate Director | Dec 1, 2025 | ||
| Christopher C Coon | Corporate Officer | Jan 1, 2016 | |
| Kelly a Elkins | Corporate Officer | Jan 1, 2022 | |
| Jennifer Kent | Corporate Director | Oct 1, 2025 | |
| Peter W Wood | Corporate Director | Jan 1, 2022 | |
| Thomas J Ryan | Corporate Director | Jan 1, 2019 | |
| David J Kumaki | Corporate Director | Jan 1, 2019 | |
| Quincy Hentzel | Corporate Director | Apr 1, 2025 | |
| Morris L Fisher | Corporate Director | Jun 1, 2013 | |
| Leslie Clinton Boothby | Corporate Director | Jan 1, 2019 | |
| Kathleen Herlihy | Corporate Director | Jan 1, 2019 | |
| Mainehealth Services | 5% Or Greater Direct Ownership Interest | Jan 1, 2019 | 100% |
| Operational/Managerial Control | Jan 1, 2019 | 100% | |
| Linda M. Terry | Corporate Director | Jan 1, 2022 | |
| Peter C Manning | Corporate Director | Jan 1, 2019 | |
| Alissa Chasse | W-2 Managing Employee | Jan 1, 2025 | |
| Daniel L Loiselle | Corporate Director | Jan 1, 2019 | |
| Kelly Champney | Corporate Officer | Jun 1, 2026 | |
| Matthew P Orlando | Corporate Director | Oct 1, 2024 | |
| Stuart H Watson | Corporate Director | Jan 1, 2022 | |
| Amanda Rand | Corporate Director | Jan 1, 2023 |
Owners & managing parties with NPI records 5
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Obstetrics & Gynecology Physician
- Biddeford, ME
- NPI 1902977077
Corporate Director
-
- Interventional Cardiology Physician
- Scarborough, ME
- NPI 1326019563
Corporate Director
Practitioners & affiliated clinicians
Affiliated clinicians 2,518
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298592000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589155200000",
"number": "1003113127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-6562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 BRIGHTON AVE",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022363",
"telephone_number": "207-662-8600",
"fax_number": "207-662-8668"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAINEHEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MAINEHEALTH",
"enumeration_date": "2011-02-25",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A",
"authorized_official_last_name": "INZANA",
"authorized_official_first_name": "LUGENE",
"authorized_official_middle_name": "ANTHONY",
"authorized_official_title_or_position": "ASSOCIATE CFO",
"authorized_official_telephone_number": "207-662-3538"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "ME",
"license": "37563",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207XX0801X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Portland, ME
- Maine Resource Development Corp
- Maine Resource Development Corporation
- Maine State Interpreters
- Maine Therapy Collective PLLC
- Maine Vocational Associates, Inc. (Maine Vocational & Rehabilitation Associates, Inc.)
- Mainehealth (MaineHealth Pharmacy Brighton Ave)
- Mainehealth
- Mainehealth (Mainehealth Behavioral Health)
- Mainehealth (Maine Medical Center Infectious Disease)
- Mainehealth (MMC Oral Surgery)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.