Ethan M Dobrow, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD21643 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-2526

NPI assigned

May 27, 2010

Last updated

Dec 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

Tufts University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dobrow.ethan.wdh@direct.partners.masshiway.net

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.

• Mass General Brigham Community Physicians Inc

  • Cardiovascular Disease Physician
  • Medford, MA
  • NPI 1548638265

  NH

  Medicare reassignment Care Compare group NPD
• Wentworth Douglass Hospital

  • General Acute Care Hospital
  • Portsmouth, NH
  • NPI 1528687829

  Diagnostic Radiology

  NPD
• Mainehealth

  dba MaineHealth Lincoln Hospital Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Damariscotta, ME
  • NPI 1316035116
  NPD (past)

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

• Wentworth Douglass Hospital

  • General Acute Care Hospital
  • Dover, NH
  • NPI 1033118104
  Care Compare affiliation
• Wentworth Douglass Hospital

  • Diabetes Educator Registered Nurse
  • Dover, NH
  • NPI 1407385198

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1093034217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "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": "207-662-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBROW",
        "first_name": "ETHAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD21643",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ME",
            "license": "MD21643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093034217",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arjang Djamali, MD
• Owen Doane, MD
• Wendy A Dobben, LMSW-CC
• Madison Grace Dobecki, PA-C
• Steven T Dobieski, MD
• Karin M Doehne, MD
• Lauren Doering-Campbell, DC, MSACN
• Katherine E Doering, LMSW-CC
• Maria R Doering
• Abigail Doherty

• Vascular & Interventional Radiology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Vascular & Interventional Radiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.