NPIMap

Individual provider Active NPI

Anna Marie Boniakowski, MD

  • Vascular Surgery Physician
  • Portland, ME
National Provider Identifier
1134565492
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD23596 Issued in ME
Practice address
887 Congress St Ste 400
Portland, ME 04102-3163
Phone
(207) 662-7127
NPI assigned
May 14, 2013
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301102522 MI
Vascular Surgery Physician 2086S0129X MD23596 ME Primary
Vascular Surgery Physician 2086S0129X 20463 NH

Addresses

Primary practice location

887 Congress St Ste 400
Portland, ME 04102-3163

Mailing address

887 Congress St Ste 400
Portland, ME 04102-3163

Other practice location 1

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (207) 730-1946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200820001455 ME Practitioner - Vascular Surgery 9032425871 Reassigns benefits to 3 organizations
I20200820002436 NH Practitioner - Vascular Surgery 9032425871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Michigan Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23596MEMDVascular Surgery Physician
20463NHMDVascular Surgery Physician
4301102522MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 17, 2020 Accepting new patients
Maine Medical Partners Single Specialty Current Accepting new patients
Maine Medical Partners Single Specialty Current Accepting new patients
Maine Medical Partners CurrentSince Aug 17, 2020 Accepting new patients
Maine Medical Partners Single Specialty CurrentSince Aug 17, 2020 Accepting new patients
Memorial Hospital Single Specialty CurrentSince Sep 1, 2020 Accepting new patients
Mainehealth CurrentSince Aug 17, 2020 Accepting new patients
Mainehealth Single Specialty Current Accepting new patients
Memorial Hospital CurrentSince Sep 1, 2020 Accepting new patients

Locations

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

887 Congress St
Portland, ME 04102
Phone (207) 662-5522

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368

96 Campus Dr
Ste 1
Scarborough, ME 04074
Phone (207) 396-5611

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: aboniakowski301416@direct.mmc.mainehealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1134565492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST STE 400",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST STE 400",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023163",
            "telephone_number": "207-662-7127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 White Mountain Hwy",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038607101",
            "country_code": "US",
            "telephone_number": "207-730-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONIAKOWSKI",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301102522",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "ME",
            "license": "MD23596",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "20463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.