Lisa A. Tabenken, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP81696 Issued in ME

Practice address

33 Sewall St
Portland, ME 04102-2603

Phone

(207) 828-2100

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Coastal Women'S Healthcare

  • Specialist
  • Scarborough, ME
  • NPI 1578674214
  NPD (past)
• Orthopaedic Associates of Portland, PA

  • Orthopaedic Surgery Physician
  • Portland, ME
  • NPI 1295729531
  NPD (past)
• Orthopaedic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Portland, ME
  • NPI 1578502068
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1124018387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABENKEN",
        "first_name": "LISA",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP81696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124018387",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon P Szczesniak, MPT
• Abigail Szotkowski
• Kevin Alexander Sztam, MD
• Colleen Szypko, DO
• Truc Ta, M.D.
• Stuart Tackett
• Adam Kyle Taft, MD
• Amy G Taisey, PA-C
• Henry P Talarico, M.D.
• Susan B Talbot, MD

• Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.