Individual provider Active NPI

Katherine K. Yanagisawa, D.O.

  • Pediatrics Physician
  • Biddeford, ME
National Provider Identifier
1174985212
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO2879 Issued in ME
Practice address
9 Healthcare Dr
Biddeford, ME 04005
Phone
(207) 282-7531
NPI assigned
Mar 28, 2016
Last updated
Jul 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DO2879 ME Primary

Addresses

Primary practice location

9 Healthcare Dr
Biddeford, ME 04005

Mailing address

9 Healthcare Dr
Biddeford, ME 04005-9449
Phone (207) 282-7531

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
I20190730000813 ME Practitioner - Pediatric Medicine 7315238227 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 15, 2019 Accepting new patients
Mainehealth CurrentSince Jul 15, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Pediatrics Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

9 Healthcare Dr
Biddeford, ME 04005
Phone (207) 282-3666

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

Interoperability endpoints

  • Direct secure messaging: kyanagisawa124947@direct.mmc.mainehealth.org

Organizations & group practices 5

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1174985212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HEALTHCARE DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059449",
            "telephone_number": "207-282-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HEALTHCARE DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "04005",
            "telephone_number": "207-282-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANAGISAWA",
        "first_name": "KATHERINE",
        "middle_name": "K.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "DO2879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.