NPIMap

Individual provider Active NPI

Genevieve Hall, MD

  • Physical Medicine & Rehabilitation Physician
  • Waterville, ME
National Provider Identifier
1194706317
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
016108 Issued in ME
Practice address
30 Chase Ave
Waterville, ME 04901-4624
Phone
(207) 872-4400
Fax
(207) 872-4621
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 016108 ME Primary

Addresses

Primary practice location

30 Chase Ave
Waterville, ME 04901-4624

Mailing address

PO Box 1898
Waterville, ME 04903-1898
Phone (207) 872-4400

Other identifiers 1

IdentifierTypeStateIssuer
30209757MedicaidNH

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
I20051026000278 ME Practitioner - Physical Medicine and Rehabilitation 9739106105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
New York Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016108MEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2011 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Dec 9, 2010 Accepting new patients
Mainehealth CurrentSince Jan 1, 2011 Accepting new patients
Maine Medical Partners CurrentSince Dec 9, 2010 Accepting new patients
Mainehealth Past Accepting new patients
John W. Hall, MD, LLC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

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

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: ghall5498@direct.mmc.mainehealth.org

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, 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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1194706317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1898",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049031898",
            "telephone_number": "207-872-4400",
            "fax_number": "207-872-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4400",
            "fax_number": "207-872-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "GENEVIEVE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ME",
            "license": "016108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209757",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.