Individual provider Active NPI

Steven Blumenthal, MD

  • Pediatrics Physician
  • Portland, ME
National Provider Identifier
1275565384
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
012914 Issued in ME
Practice address
180 Park Ave
Portland, ME 04102-2927
Phone
(207) 772-3703
Fax
(207) 773-1177
NPI assigned
Jul 7, 2006
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 012914 ME Primary

Addresses

Primary practice location

180 Park Ave
Portland, ME 04102-2927

Mailing address

75 John Roberts Rd BLDG B
South Portland, ME 04106-6967
Phone (207) 775-4151

Other identifiers 1

IdentifierTypeStateIssuer
296060099MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514002002 ME Practitioner - Pediatric Medicine 8628398641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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
012914MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2015 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Jan 1, 2015 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2015 Accepting new patients
Peds Coverage PC Pediatrics Current Accepting new patients
Mainehealth Pediatrics CurrentSince Jan 1, 2015 Accepting new patients
Mainehealth Current Accepting new patients

Locations

1577 Congress St
Portland, ME 04102
Phone (207) 662-1622

1577 Congress St
Ste 1
Portland, ME 04102
Phone (207) 662-1442

180 Park Ave
Portland, ME 04102
Phone (207) 772-3703

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

75 John Roberts Rd
Bldg B
South Portland, ME 04106
Phone (207) 662-5522

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

Interoperability endpoints

  • Direct secure messaging: sblumenthal590@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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1275565384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD BLDG B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066967",
            "telephone_number": "207-775-4151",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022927",
            "telephone_number": "207-772-3703",
            "fax_number": "207-773-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENTHAL",
        "first_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "012914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296060099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.