NPIMap

Individual provider Active NPI

Nataliia Iantsevych, FNP

  • Family Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1083209266
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP211076 Issued in ME
Practice address
92 Campus Dr Ste C
Scarborough, ME 04074-7229
Phone
(207) 797-5753
Fax
(207) 797-9571
NPI assigned
Mar 9, 2021
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP211076 ME Primary

Addresses

Primary practice location

92 Campus Dr Ste C
Scarborough, ME 04074-7229

Mailing address

92 Campus Dr Ste C
Scarborough, ME 04074-7229
Phone (207) 797-5753

Other practice location 1

1250 Forest Ave Ste 301
Portland, ME 04103-1884
Phone (207) 979-5753

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
I20210416001564 ME Practitioner - Nurse Practitioner 8921416678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
CNP211076MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince May 3, 2021 Accepting new patients
Maine Medical Partners CurrentSince May 3, 2021 Accepting new patients
Maine Medical Partners Family Current Accepting new patients
Mainehealth CurrentSince May 3, 2021 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince May 3, 2021 Accepting new patients

Locations

1250 Forest Ave
Portland, ME 04103
Phone (207) 797-5753

1250 Forest Ave
Ste 301
Portland, ME 04103
Phone (207) 797-5753

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

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

92 Campus Dr
Ste C
Scarborough, ME 04074
Phone (207) 797-5753

Interoperability endpoints

  • Direct secure messaging: niantsevych109116@direct.mmc.mainehealth.org

Organizations & group practices 6

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.

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": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1083209266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Forest Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041031884",
            "country_code": "US",
            "telephone_number": "207-979-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANTSEVYCH",
        "first_name": "NATALIIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP211076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.