NPIMap

Individual provider Active NPI

Kristina M Donnellan, AGACNP

  • Acute Care Nurse Practitioner
  • Biddeford, ME
National Provider Identifier
1285361105
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP211247 Issued in ME
Practice address
1 Medical Center Dr
Biddeford, ME 04005-9422
Phone
(207) 283-7000
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 093152-28 NH
Acute Care Nurse Practitioner 363LA2100X CNP211247 ME Primary

Addresses

Primary practice location

1 Medical Center Dr
Biddeford, ME 04005-9422

Mailing address

76 Pottle Rd
Oxford, ME 04270-3357
Phone (617) 272-6812

Other practice location 1

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220930001333 ME Practitioner - Nurse Practitioner 9032595889 Reassigns benefits to 2 organizations
I20240710000762 NH Practitioner - Nurse Practitioner 9032595889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 2365418993, 79 clinicians

Practice addresses (Care Compare)

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

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

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
093152-28NHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 5, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Memorial Hospital CurrentSince Jun 3, 2024 Accepting new patients
Memorial Hospital CurrentSince Jun 3, 2024 Accepting new patients
Memorial Hospital Current Accepting new patients
Mainehealth CurrentSince Sep 5, 2022 Accepting new patients
Mainehealth Current Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

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

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: kdonnellan73502@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.

Hospital & facility affiliations 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1285361105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 POTTLE RD",
            "city": "OXFORD",
            "state": "ME",
            "postal_code": "042703357",
            "telephone_number": "617-272-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-283-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 White Mountain Hwy",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038607101",
            "country_code": "US",
            "telephone_number": "603-356-5461",
            "fax_number": "603-356-9048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLAN",
        "first_name": "KRISTINA",
        "middle_name": "M",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NH",
            "license": "093152-28",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP211247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.