NPIMap

Individual provider Active NPI

Lucy Rosenbaum, M.D.

  • Pediatric Adolescent Medicine Physician
  • South Portland, ME
National Provider Identifier
1083077846
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD28267 Issued in ME
Practice address
75 John Roberts Rd BLDG B
South Portland, ME 04106-6967
Phone
(207) 775-4151
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD28267 ME
Pediatrics Physician 208000000X MD28267 ME
Pediatric Adolescent Medicine Physician 2080A0000X MD28267 ME Primary

Addresses

Primary practice location

75 John Roberts Rd BLDG B
South Portland, ME 04106-6967

Mailing address

75 John Roberts Rd BLDG B
South Portland, ME 04106-6967
Phone (207) 775-4151

Other identifiers 1

IdentifierTypeStateIssuer
300049958MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819001836 ME Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1951698620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

5 Bucknam Rd
Falmouth, ME 04105-1209

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2024 Accepting new patients
Mainehealth CurrentSince Oct 1, 2024 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

75 John Roberts Rd
Bldg B
South Portland, ME 04106
Phone (207) 662-5522

Interoperability endpoints

  • Direct secure messaging: lrosenbaum880705@direct.mmc.mainehealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1083077846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD BLDG B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066967",
            "telephone_number": "207-775-4151",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD BLDG B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066967",
            "telephone_number": "207-775-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "LUCY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD28267",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD28267",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "ME",
            "license": "MD28267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049958",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.