Individual provider Active NPI

Mark Charles O'Brien

  • Certified Registered Nurse Anesthetist
  • Lewiston, ME
National Provider Identifier
1174243976
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA253086 Issued in ME
Practice address
300 Main St
Lewiston, ME 04240-7041
Phone
(207) 795-0111
NPI assigned
Aug 31, 2022
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA253086 ME Primary

Addresses

Primary practice location

300 Main St
Lewiston, ME 04240-7041

Mailing address

121 Whitney Rd
Gray, ME 04039-7507
Phone (207) 653-3036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113003563 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547746109 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNA253086MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Oct 31, 2025 Accepting new patients
Bridgton Hospital CurrentSince Oct 31, 2025 Accepting new patients
Rumford Hospital CurrentSince Oct 31, 2025 Accepting new patients
Bridgton Hospital CurrentSince Oct 31, 2025 Accepting new patients
Central Maine Medical Center CurrentSince Oct 31, 2025 Accepting new patients
Rumford Hospital CurrentSince Oct 31, 2025 Accepting new patients

Locations

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 7

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1174243976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WHITNEY RD",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040397507",
            "telephone_number": "207-653-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407041",
            "telephone_number": "207-795-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA253086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.