Michael A Dedekian, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

017981 Issued in ME

Practice address

887 Congress St
Suite 320
Portland, ME 04102

Phone

(207) 662-5522

Fax

(207) 662-5527

NPI assigned

Feb 27, 2006

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 3

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

Specialty

Pediatric Medicine

Education

University of Massachusetts Medical School, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdedekian3108@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.

• Maine Medical Partners

  • Pediatrics Physician
  • Saco, ME
  • NPI 1134144090
  Medicare reassignment NPD
• Maine Medical Partners

  • Pediatric Gastroenterology Physician
  • Portland, ME
  • NPI 1992719272

  Pediatric Endocrinology

  Medicare reassignment NPD
• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Mainehealth

  • Critical Access Hospital
  • Farmington, ME
  • NPI 1922791417
  Medicare reassignment NPD
• Maine Medical Partners

  • Neurology Physician
  • Scarborough, ME
  • NPI 1215269626
  NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD
• Mainehealth

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

  • General Acute Care Hospital
  • Farmington, ME
  • NPI 1609356419
  NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1093781254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 320",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-5522",
            "fax_number": "207-662-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDEKIAN",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "224852",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "ME",
            "license": "017981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30208479",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433775099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2110318",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garreth C Debiegun, M.D.
• Heidi Frutchy Deblock, M.D.
• Katelyn Deblois, M.A CF-SLP
• Nichole Lee Decker-St Onge, MSN, CRNA, APRN
• Bart Joseph Decristoforo, P.A - C
• Kyle Stanley Deden, D.C.
• Kathryn Bailey Deep, PA-C
• Elisabeth W. Deeran, MD
• Deering Center Dental LLC
• Audrey Defusco, MD

• Pediatric Endocrinology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Pediatric Endocrinology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.