Individual provider Active NPI

Kenneth Lombard, M.D.

  • Pediatric Gastroenterology Physician
  • Portland, ME
National Provider Identifier
1013946011
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
013678 Issued in ME
Practice address
887 Congress St
Suite 410B
Portland, ME 04102-3100
Phone
(207) 662-5522
Fax
(207) 662-5526
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 013678 ME
Pediatric Gastroenterology Physician 2080P0206X 013678 ME Primary

Addresses

Primary practice location

887 Congress St
Suite 410B
Portland, ME 04102-3100

Mailing address

301 US Route 1
Building C
Scarborough, ME 04074-7609
Phone (207) 396-8600

Other identifiers 2

IdentifierTypeStateIssuer
337220099MedicaidME
30006480MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090926000044 ME Practitioner - Pediatric MedicinePractitioner - Other (Physician) 1355497710 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
013678MEMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jul 10, 2009 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Jan 1, 2014 Accepting new patients
Maine Medical Partners Pediatric Gastroenterology Current Accepting new patients
Maine Medical Partners CurrentSince Jul 10, 2009 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 410B
Portland, ME 04102
Phone (207) 662-5522

887 Congress St
Portland, ME 04102
Phone (207) 662-5522

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

Interoperability endpoints

  • Direct secure messaging: klombard931@direct.mmc.mainehealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1013946011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 410B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-662-5522",
            "fax_number": "207-662-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARD",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "013678",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "ME",
            "license": "013678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337220099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006480",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.