Individual provider Active NPI

Brad Michael Schimelman, MD

  • Nephrology Physician
  • Portland, ME
National Provider Identifier
1124028865
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
015034 Issued in ME
Practice address
1600B Congress St
Portland, ME 04102-2124
Phone
(207) 774-5222
Fax
(207) 761-4433
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 015034 ME Primary

Addresses

Primary practice location

1600B Congress St
Portland, ME 04102-2124

Mailing address

1600B Congress St
Portland, ME 04102-2124
Phone (207) 774-5222

Other identifiers 1

IdentifierTypeStateIssuer
288800099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015034MEMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Nephrology Associates P.a. Nephrology Current Accepting new patients

Locations

4 Edwards Ave
Damariscotta, ME 04543
Phone (207) 563-2601

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

272 Cottage St
Sanford, ME 04073
Phone (207) 324-8888

Organizations & group practices 1

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1124028865",
    "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": "207-774-5222",
            "fax_number": "207-761-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600B CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022124",
            "telephone_number": "207-774-5222",
            "fax_number": "207-761-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIMELMAN",
        "first_name": "BRAD",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ME",
            "license": "015034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288800099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 16, 2012; 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.