Individual provider Active NPI

Michael G Tranfaglia, PA

  • Surgical Physician Assistant
  • Portland, ME
National Provider Identifier
1093793390
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-395 Issued in ME
Practice address
887 Congress St
Suite 400
Portland, ME 04102-3100
Phone
(207) 774-6368
Fax
(207) 774-9388
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-395 ME
Surgical Physician Assistant 363AS0400X PA-395 ME Primary

Addresses

Primary practice location

887 Congress St
Suite 400
Portland, ME 04102-3100

Mailing address

1600B Congress St
Portland, ME 04102-2124
Phone (207) 774-6368

Other identifiers 2

IdentifierTypeStateIssuer
278950099MedicaidME
970019234OtherMERR MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060525000058 ME Practitioner - Physician Assistant 0840201166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-395MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Apr 13, 2020 Accepting new patients
Mainehealth CurrentSince Apr 13, 2020 Accepting new patients
Maine Cardiology Associates Current Accepting new patients

Locations

887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368

1600 Congress St
Ste B
Portland, ME 04102
Phone (207) 774-5222

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

119 Gannett Dr
South Portland, ME 04106
Phone (207) 773-0040

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1093793390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600B CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022124",
            "telephone_number": "207-774-6368",
            "fax_number": "207-774-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 400",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-774-6368",
            "fax_number": "207-774-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANFAGLIA",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA-395",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA-395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278950099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970019234",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.