NPIMap

Individual provider Active NPI

Jeremy Moretz, MD

  • Diagnostic Radiology Physician
  • Portland, ME
National Provider Identifier
1235454919
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD24387 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-0111
NPI assigned
Apr 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A119960 CA
Diagnostic Radiology Physician 2085R0202X MD24387 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7861

Other practice location 1

11234 Anderson St
Department of Radiology
Loma Linda, CA 92354-2804
Phone (909) 558-4000 ext. 15021

Other identifiers 1

IdentifierTypeStateIssuer
1235454919MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NH, ME3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160617000855 CA Practitioner - Diagnostic Radiology 8628369899 Reassigns benefits to 1 organization
I20210304001970 NH Practitioner - Diagnostic Radiology 8628369899 Reassigns benefits to 1 organization
I20210304002212 ME Practitioner - Diagnostic Radiology 8628369899 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Healthcare Partners PAGroup PAC ID 7618871245, shared by 7 NPIs, 305 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 871-2571

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2160

600 Turner St
Suite 1
Auburn, ME 04210-5093
Phone (207) 601-3333

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307
  • St Mary'S Regional Medical Center Hospital, Lewiston, ME, CCN 200034
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302
  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A119960CAMDDiagnostic Radiology Physician
MD24387MEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince May 1, 2021 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2016 Accepting new patients
Spectrum Healthcare Partners, P.a Diagnostic Radiology CurrentSince Jun 22, 2021 Accepting new patients
Insight-Premier Health LLC Diagnostic Radiology CurrentSince Mar 22, 2021 Accepting new patients
Spectrum Healthcare Partners, P.a CurrentSince Dec 28, 2021 Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince May 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

600 Turner St
Ste 1
Auburn, ME 04210
Phone (207) 601-3333

33 Sewall St
Portland, ME 04102
Phone (207) 772-0076

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

335 Brighton Ave
Portland, ME 04102
Phone (207) 662-8000

324 Gannett Dr
Ste 200
South Portland, ME 04106
Phone (207) 482-7861

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: jmoretz364586@direct.mmc.mainehealth.org
  • Direct secure messaging: jmoretz9498@direct.llu.edu

Organizations & group practices 9

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1235454919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7861"
        },
        {
            "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": "11234 Anderson St",
            "address_2": "Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4000 x15021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORETZ",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A119960",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD24387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235454919",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.