Active NPI
Connor Petrovich, MD
- Hospitalist Physician
- Brunswick, ME
National Provider Identifier
1053061895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- MD29466
- Practice address
- 123 Medical Center Dr
Brunswick, ME 04011-2652 - Phone
- (207) 373-6000
- Fax
- (207) 373-6080
- NPI assigned
- Mar 25, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | MD29466 | ME | Primary |
| Internal Medicine Physician | 207R00000X | MD29466 | ME |
Addresses
Primary practice location
123 Medical Center Dr
Brunswick, ME 04011-2652
Mailing address
123 Medical Center Dr
Brunswick, ME 04011-2652
Phone (207) 373-6000
Other practice location 1
1431 SW 1st Ave # Blitzer7
Ocala, FL 34471-6500
Phone (352) 401-8311
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
- Mainehealth Mid Coast Hospital
- Mainehealth Maine Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
Locations
123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- cpetrovich915713@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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Multi-Specialty Clinic/Center
- Brunswick, ME
- NPI 1902422561
-
- General Acute Care Hospital
- Brunswick, ME
- NPI 1932164795
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1053061895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 MEDICAL CENTER DR",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040112652",
"telephone_number": "207-373-6000",
"fax_number": "207-373-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 MEDICAL CENTER DR",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040112652",
"telephone_number": "207-373-6000",
"fax_number": "207-373-6080"
}
],
"practiceLocations": [
{
"address_1": "1431 SW 1st Ave # Blitzer7",
"address_purpose": "LOCATION",
"city": "Ocala",
"state": "FL",
"postal_code": "344716500",
"country_code": "US",
"telephone_number": "352-401-8311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETROVICH",
"first_name": "CONNOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-25",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "ME",
"license": "MD29466",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ME",
"license": "MD29466",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.