Individual provider Active NPI

Rachel Garoufalis, D.M.D.

  • Endodontics
  • Portland, ME
National Provider Identifier
1124454665
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DEN4515 Issued in ME
Practice address
716 Stevens Ave
Portland, ME 04103-2656
Phone
(207) 221-4225
NPI assigned
Sep 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 04124 NH
Endodontics 1223E0200X DEN4515 ME Primary

Addresses

Primary practice location

716 Stevens Ave
Portland, ME 04103-2656

Mailing address

82 Coyle St.
Portland, ME 04101

Other names 1

  • Rachel McKee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629002562 MA Order and Referring Only - DentistPractitioner - Dentist 6800188400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN4515MEMDEndodontist
04124NHMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Associates PastSince Oct 1, 2021 Accepting new patients

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": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1124454665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 COYLE ST.",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032656",
            "telephone_number": "207-221-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAROUFALIS",
        "first_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NH",
            "license": "04124",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "ME",
            "license": "DEN4515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "MCKEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.