NPIMap

Organization Active NPI

Maine Medical Partners

Doing business as Maine Medical Partners Women's Health

  • Obstetrics & Gynecology Physician
  • Portland, ME
National Provider Identifier
1104921535
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MAINE MEDICAL PARTNERS
Doing business as
Maine Medical Partners Women's Health
Practice address
887 Congress St
Suite 200
Portland, ME 04102-3100
Phone
(207) 771-5549
Fax
(207) 771-7834
NPI assigned
Sep 13, 2006
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Stephen J Kasabian
Title
President
Phone
(207) 661-2000

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ME
Women's Health Nurse Practitioner 363LW0102X ME
Advanced Practice Midwife 367A00000X ME
Obstetrics & Gynecology Physician 207V00000X ME Primary
Reproductive Endocrinology Physician 207VE0102X ME
Maternal & Fetal Medicine Physician 207VM0101X ME
Gynecologic Oncology Physician 207VX0201X ME

Addresses

Primary practice location

887 Congress St
Suite 200
Portland, ME 04102-3100

Mailing address

300 Southborough Dr
South Portland, ME 04106-6914
Phone (207) 661-2000

Other identifiers 4

IdentifierTypeStateIssuer
119910021MedicaidME
119910016MedicaidME
119910023MedicaidME
30005726MedicaidNH

Other names 1

  • Maine Medical Partners Women's Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331000274 ME Part B Supplier - Clinic/Group Practice 9335043967 Receives reassigned benefits from 244 practitioners
1 other NPI on this enrollment
Practice locations: Waterville, ME; South Portland, ME; Scarborough, ME; Rockport, ME; Portland, ME; Lewiston, ME; Augusta, ME

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 249

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 249

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1104921535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTHBOROUGH DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-661-2000",
            "fax_number": "207-661-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-771-5549",
            "fax_number": "207-771-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MEDICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "KASABIAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-661-2000"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": null,
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "ME",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119910021",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119910016",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119910023",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30005726",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Maine Medical Partners Women's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maine Medical Partners Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.