Individual provider Active NPI

Jennifer K Deane, FNP

  • Family Nurse Practitioner
  • Westbrook, ME
National Provider Identifier
1265865323
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP131077 Issued in ME
Practice address
1 Harnois Ave
2ND Floor
Westbrook, ME 04092-4392
Phone
(207) 661-3400
Fax
(207) 661-3401
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP131077 ME Primary

Addresses

Primary practice location

1 Harnois Ave
2ND Floor
Westbrook, ME 04092-4392

Mailing address

190 Riverside St
Suite 6B
Portland, ME 04103-1073
Phone (207) 661-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140114000768 ME Practitioner - Nurse Practitioner 7517195852 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
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)

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

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP131077MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 13, 2013 Accepting new patients
Mainehealth CurrentSince Dec 1, 2013 Accepting new patients
Maine Medical Partners CurrentSince May 7, 2017 Accepting new patients
Mainehealth CurrentSince Sep 13, 2013 Accepting new patients
Maine Medical Partners CurrentSince Sep 13, 2013 Accepting new patients
Maine Medical Partners CurrentSince Sep 13, 2013 Accepting new patients
Mainehealth Current 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

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

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

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

Interoperability endpoints

  • Direct secure messaging: jkelley81155@direct.mmc.mainehealth.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1265865323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST",
            "address_2": "SUITE 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073",
            "telephone_number": "207-661-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARNOIS AVE",
            "address_2": "2ND FLOOR",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924392",
            "telephone_number": "207-661-3400",
            "fax_number": "207-661-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANE",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP131077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.