NPIMap

Individual provider Active NPI

Daniel J Diekema, MD

  • Infectious Disease Physician
  • South Portland, ME
National Provider Identifier
1104801489
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD14027 Issued in ME
Practice address
41 Donald B Dean Dr
South Portland, ME 04106-3252
Phone
(207) 661-7901
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28731 IA
Infectious Disease Physician 207RI0200X 28731 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 28731 IA
Infectious Disease Physician 207RI0200X MD14027 ME Primary

Addresses

Primary practice location

41 Donald B Dean Dr
South Portland, ME 04106-3252

Mailing address

41 Donald B Dean Dr
South Portland, ME 04106-3252
Phone (207) 661-7901

Other identifiers 2

IdentifierTypeStateIssuer
47989OtherIAWELLMARK BCBS
0098376MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221028002215 ME Practitioner - Infectious DiseasePractitioner - Internal Medicine 0840332805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Vanderbilt University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

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
28731IAMDInfectious Disease Physician
MD14027MEMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners Internal Medicine Current Accepting new patients
Maine Medical Partners CurrentSince Oct 1, 2022 Accepting new patients
Maine Medical Partners CurrentSince Oct 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2022 Accepting new patients
Mainehealth CurrentSince Oct 1, 2022 Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

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

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

41 Donald B Dean Dr
#B
South Portland, ME 04106
Phone (207) 661-7901

Interoperability endpoints

  • Direct secure messaging: ddiekema1435@uihcdirect.org

Organizations & group practices 7

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1104801489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 DONALD B DEAN DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063252",
            "telephone_number": "207-661-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 DONALD B DEAN DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063252",
            "telephone_number": "207-661-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEKEMA",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "28731",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IA",
            "license": "28731",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "28731",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "ME",
            "license": "MD14027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "47989",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098376",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.