Vascular Care Group Maine LLC
Organization Active NPI Vascular Surgery Physician · S Portland, ME
NPI 1053019588 · NPPES record last updated Jul 24, 2023
Key facts
- NPI
- 1053019588
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- Legal business name
- VASCULAR CARE GROUP MAINE LLC
- Practice address
- 400 Southborough Dr Ste 400-102
S Portland, ME 04106-3249 - Phone
- (207) 464-8288
- NPI assigned
- Feb 23, 2023
- Organization subpart
- No
Authorized official
- Name
- Daniel Gorin, MD
- Title
- Owner/Member
- Phone
- (508) 775-1984
Practitioners 5
-
Nathan Jacob Aranson, M.D.
-
Amber Erin Schaub, PA-C
-
Daniel R Gorin, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 20D2339394 | Vascular Care Group, the | Certificate of waiver | Mar 1, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230825000535 | ME | Part B Supplier - Clinic/Group Practice | 6002279932 |
Receives reassigned benefits from 4 practitioners Practice locations: S Portland, ME |
National Provider Directory
Locations
400 Southborough Dr
Ste 400102
South Portland, ME 04106
Phone (207) 464-8288
400 Southborough Dr
Ste 102
South Portland, ME 04106
400 Southborough Dr
#400102
South Portland, ME 04106
127 Long Sands Rd
Unit 6A
York, ME 03909
Phone (207) 351-3715
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | Yes |
Addresses
Primary practice location
400 Southborough Dr Ste 400-102
S Portland, ME 04106-3249
Mailing address
100 Camp St
Hyannis, MA 02601-3063
Phone (508) 775-1984
Other names
- The Vascular Care Group Maine LLC
Other providers in S Portland, ME
- Ronald A Reid
- Patricia Lynn Rutka
- Priscilla Diane Skerry
- The Opportunity Alliance
- Jocelyn Vachon
- Tany Walker
- Mara Whiteford
- Deborah A Williams
All providers in S Portland, ME · Vascular Surgery Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.