Individual provider Active NPI

William Dean Jeanblanc, MD

  • Geriatric Psychiatry Physician
  • Portland, ME
National Provider Identifier
1083727606
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
MD16127 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-2816
Fax
(207) 662-6783
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD16127 ME
Geriatric Psychiatry Physician 2084P0805X MD16127 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2816

Other practice location 1

66 Bramhall St
Portland, ME 04102-3344
Phone (207) 662-3101

Other practice location 2

216 Vaughan St
Portland, ME 04102-3204
Phone (207) 662-2221

Other practice location 3

123 Andover Rd
Westbrook, ME 04092-3848
Phone (207) 761-2200

Other identifiers 1

IdentifierTypeStateIssuer
3000355MedicaidNH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050627000828 ME Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 4688619919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
State University of Ny Upstate Medical University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

66 Bramhall St
FL 1
Portland, ME 04102-3355
Phone (207) 662-3157

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD16127MEMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jan 1, 2008 Accepting new patients
Mainehealth CurrentSince Jan 1, 2008 Accepting new patients

Locations

66 Bramhall St
Fl 1
Portland, ME 04102
Phone (207) 662-3101

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

66 Bramhall St
Portland, ME 04102
Phone (207) 662-3157

216 Vaughan St
Portland, ME 04102
Phone (207) 662-2221

123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200

Interoperability endpoints

  • Direct secure messaging: wjeanblanc870@direct.mmc.mainehealth.org

Organizations & group practices 3

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1083727606",
    "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": "207-662-2816",
            "fax_number": "207-662-6783"
        },
        {
            "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": "207-662-2816",
            "fax_number": "207-662-6783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023344",
            "country_code": "US",
            "telephone_number": "207-662-3101",
            "fax_number": "207-662-6783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Vaughan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023204",
            "country_code": "US",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Andover Rd",
            "address_purpose": "LOCATION",
            "city": "Westbrook",
            "state": "ME",
            "postal_code": "040923848",
            "country_code": "US",
            "telephone_number": "207-761-2200",
            "fax_number": "207-761-2108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANBLANC",
        "first_name": "WILLIAM",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD16127",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "ME",
            "license": "MD16127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000355",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.