NPIMap

Individual provider Active NPI

Debra A Rothenberg, M.D.

  • Family Medicine Physician
  • Portland, ME
National Provider Identifier
1245265776
Registry record updated Dec 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
015974 Issued in ME
Practice address
272 Congress St
Portland, ME 04101-3637
Phone
(207) 874-2466
Fax
(207) 774-4625
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 015974 ME Primary

Addresses

Primary practice location

272 Congress St
Portland, ME 04101-3637

Mailing address

39 Wallace Ave
South Portland, ME 04106-6143
Phone (207) 761-0650

Other identifiers 1

IdentifierTypeStateIssuer
296990099MedicaidME

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
I20050609000112 ME Practitioner - Family Practice 7810930963 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1990
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)

272 Congress St
Portland, ME 04101-3637
Phone (207) 874-2466

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 nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015974MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth Family Medicine CurrentSince Sep 1, 2002 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth CurrentSince Sep 1, 2002 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth CurrentSince Jan 1, 2015 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Mainehealth Family Medicine 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

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

39 Wallace Ave
South Portland, ME 04106
Phone (207) 761-0650

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

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

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

Interoperability endpoints

  • Direct secure messaging: drothenberg1106@direct.mmc.mainehealth.org

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 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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1245265776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALLACE AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066143",
            "telephone_number": "207-761-0650",
            "fax_number": "207-761-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013637",
            "telephone_number": "207-874-2466",
            "fax_number": "207-774-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHENBERG",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "015974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296990099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.