Individual provider Active NPI

Ilsa Annetta Shulman, MD

  • Internal Medicine Physician
  • Bangor, ME
National Provider Identifier
1023082674
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD17267 Issued in ME
Practice address
900 Broadway
Bangor, ME 04401-1900
Phone
(207) 907-3300
Fax
(207) 907-1923
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD17267 ME Primary

Addresses

Primary practice location

900 Broadway
Bangor, ME 04401-1900

Mailing address

C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8560

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ishulman613675@direct-prd.goodhelpconnections.org

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
I20070508000133 ME Practitioner - Internal Medicine 1153217161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pittsburgh School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

900 Broadway
Bangor, ME 04401-1900
Phone (207) 907-3777

Hospital & facility affiliations

  • St Joseph Homecare Home health agency, Bangor, ME, CCN 207033
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Hospital CurrentSince Nov 1, 2017 Accepting new patients

Locations

900 Broadway
Bldg 4
Bangor, ME 04401
Phone (207) 907-3276

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

900 Broadway
Bangor, ME 04401
Phone (207) 907-3300

900 Broadway
Bldg 1
Bangor, ME 04401
Phone (207) 907-1187

600 Main St
Bldg 11
Bar Harbor, ME 04609
Phone (207) 288-1600

Interoperability endpoints

  • Direct secure messaging: ishulman1155716@direct.bsmhealth.org

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1023082674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8560",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044011900",
            "telephone_number": "207-907-3300",
            "fax_number": "207-907-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "ILSA",
        "middle_name": "ANNETTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD17267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ishulman613675@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "900 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044011900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.