NPIMap

Individual provider Active NPI

Pamela Gardiner, MD

  • Family Medicine Physician
  • Brunswick, ME
National Provider Identifier
1023030020
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD14780 Issued in ME
Practice address
114 Bath Rd
Brunswick, ME 04011-2606
Phone
(207) 798-4400
Fax
(207) 798-4452
NPI assigned
Jul 25, 2006
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD14780 ME Primary

Addresses

Primary practice location

114 Bath Rd
Brunswick, ME 04011-2606

Mailing address

PO Box 9746
Portland, ME 04104-5040
Phone (207) 828-2449

Other identifiers 1

IdentifierTypeStateIssuer
300100099MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pamela.gardiner.1@5857.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000749 ME Practitioner - Family Practice 6608867874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians

Practice addresses (Care Compare)

74 Baribeau Dr
Brunswick, ME 04011-3218
Phone (207) 798-4050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Family Medicine CurrentSince Jul 1, 1991 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients

Locations

68 Graham St
Biddeford, ME 04005
Phone (207) 283-1441

114 Bath Rd
Brunswick, ME 04011
Phone (207) 798-4400

74 Baribeau Dr
Brunswick, ME 04011
Phone (207) 798-4050

510 Main St
Gorham, ME 04038
Phone (207) 216-2118

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
  • Direct secure messaging: pamela.gardiner.1@5857.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1023030020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-828-2449",
            "fax_number": "207-828-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BATH RD",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112606",
            "telephone_number": "207-798-4400",
            "fax_number": "207-798-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "PAMELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD14780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300100099",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pamela.gardiner.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "114 Bath Rd",
            "city": "Brunswick",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040112606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.