NPIMap

Organization Active NPI

Maine Medical Partners

Doing business as Maine Childrens Cancer Program

  • Pediatric Hematology & Oncology Physician
  • Scarborough, ME
National Provider Identifier
1073527388
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
MAINE MEDICAL PARTNERS
Doing business as
Maine Childrens Cancer Program
Practice address
100 Campus Dr
Unit 107
Scarborough, ME 04074-9692
Phone
(207) 885-7565
NPI assigned
Jul 29, 2006
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Stephen J Kasabian
Title
President
Phone
(207) 661-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X
Clinical Social Worker 1041C0700X
Pediatric Hematology & Oncology Physician 2080P0207X Primary

Addresses

Primary practice location

100 Campus Dr
Unit 107
Scarborough, ME 04074-9692

Mailing address

300 Southborough Dr
Suite 201
South Portland, ME 04106-6914
Phone (207) 661-2000

Other identifiers 1

IdentifierTypeStateIssuer
126770000MedicaidME

Other names 1

  • Maine Childrens Cancer Program Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050401000844 ME Part B Supplier - Clinic/Group Practice 9335043967 Receives reassigned benefits from 256 practitioners
1 other NPI on this enrollment
Practice locations: Portland, ME; Scarborough, ME

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 259

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 259

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1073527388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTHBOROUGH DR",
            "address_2": "SUITE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-661-2000",
            "fax_number": "207-661-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS DR",
            "address_2": "UNIT 107",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749692",
            "telephone_number": "207-885-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MEDICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "KASABIAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-661-2000"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126770000",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Maine Childrens Cancer Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maine Childrens Cancer Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.