Individual provider Active NPI

Julie A Cekleniak, MD

  • Internal Medicine Physician
  • Portland, ME
National Provider Identifier
1174556005
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
016037 Issued in ME
Practice address
84 Marginal Way
Suite 700
Portland, ME 04101-2443
Phone
(207) 774-5816
Fax
(207) 523-8597
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

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
I20050616000707 ME Practitioner - Internal Medicine 6901840321 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016037MEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Maine Current Accepting new patients
State of Maine CurrentSince Jan 21, 2024 Accepting new patients

Locations

109 Capitol St
#11
Augusta, ME 04330

656 State St
Bangor, ME 04401
Phone (207) 941-4000

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016037 ME Primary
Hospitalist Physician 208M00000X 016037 ME

Addresses

Primary practice location

84 Marginal Way
Suite 700
Portland, ME 04101-2443

Mailing address

100 Foden Rd, West
Suite 203
South Portland, ME 04106-2327
Phone (207) 828-0361

Other identifiers 2

IdentifierTypeStateIssuer
294430099MedicaidME
30203402MedicaidNH

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1174556005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN RD, WEST",
            "address_2": "SUITE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062327",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MARGINAL WAY",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012443",
            "telephone_number": "207-774-5816",
            "fax_number": "207-523-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEKLENIAK",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "016037",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "016037",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294430099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203402",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.