NPIMap

Individual provider Active NPI

Ellis A Johnson, MD

  • Internal Medicine Physician
  • Westbrook, ME
National Provider Identifier
1215196985
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18827 Issued in ME
Practice address
1 Harnois Ave
Westbrook, ME 04092-4392
Phone
(207) 662-1340
Fax
(207) 662-1341
NPI assigned
Jun 6, 2008
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 MD18827 ME Primary
Hospitalist Physician 208M00000X MD18827 ME

Addresses

Primary practice location

1 Harnois Ave
Westbrook, ME 04092-4392

Mailing address

1 Harnois Ave Ste 1B
Westbrook, ME 04092-4395
Phone (207) 662-1340

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4618

Other practice location 2

5 Bucknam Rd Ste 2B
Falmouth, ME 04105-1209
Phone (207) 781-1600

Other identifiers 1

IdentifierTypeStateIssuer
32000667MedicaidNH

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
I20110809000905 ME Practitioner - Internal Medicine 7113196064 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

1 Harnois Ave
Westbrook, ME 04092-4392
Phone (207) 662-1360

1 Harnois Ave
Westbrook, ME 04092-4395

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 1, 2011 Accepting new patients
Maine Medical Partners CurrentSince Mar 27, 2012 Accepting new patients
Maine Medical Partners Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2011 Accepting new patients
Maine Medical Partners CurrentSince Jan 12, 2019 Accepting new patients
Maine Medical Partners Internal Medicine Current Accepting new patients
Mainehealth CurrentSince Jul 1, 2011 Accepting new patients
Mainehealth CurrentSince Dec 1, 2013 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2011 Accepting new patients
Mainehealth Internal Medicine PastSince Mar 20, 2025 Accepting new patients
Mainehealth Past Accepting new patients

Locations

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

272 Congress St
Portland, ME 04101
Phone (207) 874-2466

5 Bucknam Rd
Ste 2B
Portland, ME 04105
Phone (207) 662-1622

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

1 Harnois Ave
Westbrook, ME 04092
Phone (207) 662-1340

1 Harnois Ave
Ste 1B
Westbrook, ME 04092
Phone (207) 662-1340

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

582 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3233

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

Interoperability endpoints

  • Direct secure messaging: ejohnson5895@direct.mmc.mainehealth.org

Organizations & group practices 12

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1215196985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARNOIS AVE STE 1B",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924395",
            "telephone_number": "207-662-1340",
            "fax_number": "207-662-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARNOIS AVE",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924392",
            "telephone_number": "207-662-1340",
            "fax_number": "207-662-1341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Bucknam Rd Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Falmouth",
            "state": "ME",
            "postal_code": "041051209",
            "country_code": "US",
            "telephone_number": "207-781-1600",
            "fax_number": "207-781-1609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELLIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD18827",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD18827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32000667",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.