NPIMap

Individual provider Active NPI

Fotini Polidoro, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, ME
National Provider Identifier
1194343822
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA223079 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-2526
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA223079 ME Primary
Critical Care Medicine Registered Nurse 163WC0200X 689663-1 NY

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2526

Other names 1

  • Fotini Zachariadis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230104001599 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436529617 Reassigns benefits to 2 organizations
I20260226000462 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436529617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

181 Main St
Norway, ME 04268-5664
Phone (207) 743-5933

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

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
689663-1NYMDCritical Care Medicine Registered Nurse
RNA223079MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital & Nursing Home CurrentSince Jan 19, 2026 Accepting new patients
Mainehealth CurrentSince Jan 23, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Nathan Littauer Hospital Association CurrentSince Jan 19, 2026 Accepting new patients
Mainehealth CurrentSince Jan 23, 2023 Accepting new patients
Columbia School of Nursing PastSince Jul 9, 2023 Accepting new patients

Locations

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

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

Organizations & group practices 8

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.

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1194343822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2526"
        },
        {
            "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": "207-662-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIDORO",
        "first_name": "FOTINI",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA223079",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "689663-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FOTINI",
            "last_name": "ZACHARIADIS",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.