Laura L Blaisdell, MD/MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

017899 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-2911

NPI assigned

Nov 21, 2006

Last updated

Mar 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lblaisdell31246@direct.mmc.mainehealth.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Mercy Hospital

  dba Mercy Medical Associates

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1427313048

  Corporate Officer

  CMS ownership
• Mercy Hospital

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1629078712

  Corporate Officer

  CMS ownership

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.

• Maine Medical Partners

  dba Maine Medical Partners Family Medicine

  • Family Medicine Physician
  • Scarborough, ME
  • NPI 1467477349
  Medicare reassignment NPD
• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba MaineHealth Maine Medical Center

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1760436216
  NPD
• Mainehealth

  dba MaineHealth Medical Group-Primary Care

  • Clinic/Center
  • Portland, ME
  • NPI 1487346722

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1063587343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "LAURA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "EC-05-003",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "017899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Blackborow, LCSW
• Christopher Michael Blades
• Elizabeth Blades, FNP
• Valerie Blais, MT
• Gregory Blaisdell, MD
• Oaklin Blaisdell, LCSW
• Hayley Marie Blaise, CRNA
• Jeffrey Blake, LCSW
• Lori E B Blake
• Rachael Y Blake, MD

• Pediatrics Physician in Portland, ME
• Providers in Portland, ME by specialty
• Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.