NPIMap

Individual provider Active NPI

Krystian W Bigosinski, MD

  • Sports Medicine (Family Medicine) Physician
  • South Portland, ME
National Provider Identifier
1245450832
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD20416 Issued in ME
Practice address
100 Brickhill Avenue
Suite 303
South Portland, ME 04106
Phone
(207) 773-0040
Fax
(207) 824-4900
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 036121017 IL
Sports Medicine (Family Medicine) Physician 207QS0010X MD20416 ME Primary

Addresses

Primary practice location

100 Brickhill Avenue
Suite 303
South Portland, ME 04106

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
036121017OtherILIL STATE MEDICAL LICENSE
ML20008426OtherWASTATE MEDICAL LISCENCE

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
I20150303001291 ME Practitioner - Sports MedicinePractitioner - Family Practice 3375680010 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2005
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
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 773-0040

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

265 Western Ave
1 MMP Dermatology
South Portland, ME 04106-6942
Phone (207) 661-0100

730 Ctr St
Auburn, ME 04210-6316
Phone (207) 783-3450

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20416MEMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jan 15, 2015 Accepting new patients
Maine Medical Partners CurrentSince Jan 21, 2021 Accepting new patients
Mainehealth CurrentSince Jan 15, 2015 Accepting new patients
Mainehealth CurrentSince Jan 15, 2015 Accepting new patients
Mainehealth Sports Medicine CurrentSince Jan 15, 2015 Accepting new patients
Maine Medical Partners CurrentSince Jan 15, 2015 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth Current Accepting new patients
Midwest Orthopaedics at Rush, LLC Past Accepting new patients

Locations

5 Bucknam Rd
Ste 1D
Falmouth, ME 04105
Phone (207) 781-1551

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

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

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

100 Brickhill Ave
Ste 303
South Portland, ME 04106
Phone (207) 773-0040

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: kbigosinski115628@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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1245450832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE ONE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVENUE",
            "address_2": "SUITE 303",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-773-0040",
            "fax_number": "207-824-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGOSINSKI",
        "first_name": "KRYSTIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036121017",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD20416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE MEDICAL LICENSE",
            "identifier": "036121017",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LISCENCE",
            "identifier": "ML20008426",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.