Individual provider Active NPI

Abby A Markham, MD

  • Pediatrics Physician
  • Portland, ME
National Provider Identifier
1164718540
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD20135 Issued in ME
Practice address
22 Bramhall Street
Maine Medical Center Dept of Pediatrics
Portland, ME 04103
Phone
(207) 662-2541
Fax
(207) 662-3172
NPI assigned
Jun 23, 2011
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X MD20135 ME Primary

Addresses

Primary practice location

22 Bramhall Street
Maine Medical Center Dept of Pediatrics
Portland, ME 04103

Mailing address

22 Bramhall Street
Maine Medical Center Dept of Pediatrics
Portland, ME 04102
Phone (207) 662-2541

Other names 1

  • Abby Gross Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140616000486 ME Practitioner - Pediatric Medicine 8628202561 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 1, 2014 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Jul 1, 2014 Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2014 Accepting new patients
Mainehealth CurrentSince Jul 1, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Pediatrics Past Accepting new patients

Locations

5 Bucknam Rd
Ste 2A
Falmouth, ME 04105
Phone (207) 781-1775

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

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

Interoperability endpoints

  • Direct secure messaging: agross9556@direct.mmc.mainehealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1164718540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL STREET",
            "address_2": "MAINE MEDICAL CENTER DEPT OF PEDIATRICS",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-2541",
            "fax_number": "207-662-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL STREET",
            "address_2": "MAINE MEDICAL CENTER DEPT OF PEDIATRICS",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-662-2541",
            "fax_number": "207-662-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "ABBY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD20135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABBY",
            "last_name": "GROSS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.