NPIMap

Individual provider Active NPI

Caitlin Civiello, M.D.

  • Emergency Medicine Physician
  • Portland, ME
National Provider Identifier
1265844393
Registry record updated Jun 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD21313 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-0111
NPI assigned
May 23, 2014
Last updated
Jun 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD21313 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-0111

Other names 1

  • Dr. Caitlin Hynes Former name

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
I20161216000489 ME Practitioner - Emergency Medicine 6800012600 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluewater Emergency Partners of Brunswick, LLCGroup PAC ID 3375774227, 151 clinicians
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

123 Medical Ctr Dr
Brunswick, ME 04011-2652
Phone (207) 373-6000

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

22 Station Ave
Brunswick, ME 04011-2092

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2019 Accepting new patients
Bluewater Emergency Partners of Brunswick, LLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Mainehealth CurrentSince Jan 1, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jul 1, 2017 Accepting new patients
Bluewater Emergency Partners of Calais, LLC Dba: Bluewater Urgent Care Emergency Medicine Past Accepting new patients

Locations

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

181 Main St
Norway, ME 04268
Phone (207) 743-5933

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

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • Direct secure messaging: cciviello12399@direct.mmc.mainehealth.org

Organizations & group practices 6

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1265844393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-0111"
        },
        {
            "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": [],
    "basic": {
        "last_name": "CIVIELLO",
        "first_name": "CAITLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD21313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "HYNES",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.