NPIMap

Individual provider Active NPI

Shinya Amano, M.D.

  • Dermatology Physician
  • Portland, ME
National Provider Identifier
1184006108
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD23729 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-0111
NPI assigned
Jun 25, 2015
Last updated
Jul 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 278298 MA
Dermatology Physician 207N00000X MD23729 ME Primary
Dermatopathology Physician 207ND0900X MD23729 ME
Dermatopathology (Pathology) Physician 207ZD0900X MD23729 ME

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-5979

Other identifiers 1

IdentifierTypeStateIssuer
1184006108MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707003200 ME Practitioner - DermatologyPractitioner - Other (Physician) 9133410566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Massachusetts Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

1601 Congress St
Suite 1
Portland, ME 04102-2102
Phone (207) 661-0100

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

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
Removal of skin lesions24
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278298MAMDDermatology Physician
MD23729MEMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 27, 2020 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners Dermatology CurrentSince Jul 27, 2020 Accepting new patients
Mainehealth CurrentSince Jul 27, 2020 Accepting new patients
Mainehealth Current Accepting new patients

Locations

1601 Congress St
Ste 1
Portland, ME 04102
Phone (207) 661-0100

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

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

265 Western Ave
Ste 1
South Portland, ME 04106
Phone (207) 661-0100

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: samano299104@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.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1184006108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052138",
            "country_code": "US",
            "telephone_number": "508-334-5979",
            "fax_number": "508-334-5232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMANO",
        "first_name": "SHINYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "278298",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ME",
            "license": "MD23729",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "ME",
            "license": "MD23729",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "ME",
            "license": "MD23729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184006108",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.