Active NPI
Elizaveta V Zviaguin, DDS, MD
- Oral & Maxillofacial Surgery (D.M.D.)
- Portland, ME
National Provider Identifier
1104142470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- DEN5249
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-4078
- NPI assigned
- Apr 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | MD29441 | ME | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | DEN5249 | ME | Primary |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | DD4981 | NM |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4078
Other practice location 1
190 Park Ave
Portland, ME 04102-2910
Phone (207) 819-6600
Other practice location 2
1801 Camino De Salud NE Ste 1100
Albuquerque, NM 87102-4516
Phone (505) 925-7918
Other practice location 3
117 W 75th St
Apt 8
New York, NY 10023-1823
Phone (718) 300-2142
Other names 1
- Elizaveta V Rogol
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SRMC@direct.health.unm.edu | ||
| Direct Messaging Address | UNMMG@direct.health.unm.edu | ||
| Direct Messaging Address | UNMH@direct.health.unm.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Oral Surgery
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
190 Park Ave
Portland, ME 04102-2910
Phone (207) 819-6600
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
92 Campus Dr
Scarborough, ME 04074-7229
Hospital & facility affiliations
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- Quality
- 75.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.92
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| Unm Medical Group Inc | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
190 Park Ave
Portland, ME 04102
Phone (207) 819-6600
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
1801 Camino de Salud NE
Ste 1100
Albuquerque, NM 87102
Phone (505) 925-7755
800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476
3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Interoperability endpoints
- ezviaguin924527@direct.mmc.mainehealth.org
Organizations & group practices 5
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.
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Family Medicine Physician
- Portland, ME
- NPI 1629761978
-
- Community/Retail Pharmacy
- Albuquerque, NM
- NPI 1417330044
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1104142470",
"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": "207-662-4078"
},
{
"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": "207-662-4078"
}
],
"practiceLocations": [
{
"address_1": "190 Park Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041022910",
"country_code": "US",
"telephone_number": "207-819-6600",
"fax_number": "207-797-9571",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1801 Camino De Salud NE Ste 1100",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871024516",
"country_code": "US",
"telephone_number": "505-925-7918",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "117 W 75th St",
"address_2": "Apt 8",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100231823",
"country_code": "US",
"telephone_number": "718-300-2142",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZVIAGUIN",
"first_name": "ELIZAVETA",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "DDS, MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-12",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "ME",
"license": "MD29441",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "ME",
"license": "DEN5249",
"primary": true
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "NM",
"license": "DD4981",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "SRMC@direct.health.unm.edu",
"affiliation": "N",
"address_1": "3001 Broadmoor Blvd NE",
"city": "Rio Rancho",
"state": "NM",
"country_code": "US",
"postal_code": "871442100",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UNMMG@direct.health.unm.edu",
"affiliation": "N",
"address_1": "800 Bradbury Dr SE Ste 116",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871064310",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "UNMH@direct.health.unm.edu",
"affiliation": "N",
"address_1": "2211 Lomas Blvd NE",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871062719",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ELIZAVETA",
"last_name": "ROGOL",
"middle_name": "V",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.