Mary C. Ottolini, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD19738 Issued in DC

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-6711

Fax

(207) 662-6063

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

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: mottolini270362@direct.mmc.mainehealth.org

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.

• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502

  Multi-Specialty

  Medicare reassignment NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

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

  dba MaineHealth Franklin Hospital

  • General Acute Care Hospital
  • Farmington, ME
  • NPI 1609356419
  NPD
• Mainehealth

  dba MaineHealth Maine Medical Center

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

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1073602884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102978",
            "telephone_number": "202-884-2182"
        },
        {
            "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": "207-662-6711",
            "fax_number": "207-662-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTOLINI",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD22944",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD19738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024354500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1822411100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6725961",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "0061",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Jennifer Ostapenko, MD
• Osteopathic Wellness LLC
• Robyn L. Ostrander, MD
• Jonathan Oswald, MD
• Edward Timothy Ottati
• Leah Christensen Ottow, LCSW
• Nicole Ouellet, LMSW-CC
• Chelsea Ann Ouellette, MS OTR/L
• Dylan T Ouellette, CRNA
• Emma Ouellette

• 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 May 21, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.