NPIMap

Organization Active NPI

Northern Maine Medical Center

  • Multi-Specialty Clinic/Center
  • Madawaska, ME
National Provider Identifier
1285487330
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NORTHERN MAINE MEDICAL CENTER
Practice address
460 Main St
Madawaska, ME 04756-1088
Phone
(207) 728-6359
NPI assigned
Apr 9, 2024
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Jeffrey Zewe
Title
Ceo
Phone
(207) 834-1411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

460 Main St
Madawaska, ME 04756-1088

Mailing address

194 E Main St
Fort Kent, ME 04743-1428
Phone (207) 834-1850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240111004081 ME Part A Provider - Critical Access Hospital 3375455207 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Madawaska, ME; Fort Kent, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285487330. Details of each certification follow.

Hospital certification: CCN 201317

Legal name
NORTHERN MAINE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 21, 2024
Last certification
Nov 21, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1940 in ME
Enrollment address
194 E Main St
Fort Kent, ME 47431428
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Northern Maine Medical CenterCCN 201317 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
NMMC Pharmacy12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gisele Dionne Individual Corporate DirectorBoard Member Jan 30, 2019
Lucie Tabor Individual Corporate DirectorBoard Member Jan 15, 2021
Daniel Vaillancourt Individual Corporate DirectorBoard Member Jan 1, 2020
John Ezzy Individual Corporate DirectorBoard Member Jan 1, 2022
Steven Ouellette Individual Corporate DirectorBoard Member Jan 15, 2021
Jeffrey Zewe Individual Corporate OfficerCeo May 1, 2022
W-2 Managing EmployeeCeo May 1, 2022
Aaron Teachout Individual Corporate OfficerCfo Sep 30, 2021
W-2 Managing EmployeeCfo Sep 30, 2021
Norman L Fournier Individual Corporate DirectorBoard Member Jan 15, 2021
Donald Guimond Individual Corporate DirectorBoard Member, Chair Jul 21, 2015
Erin Soucy Individual Corporate DirectorBoard Member, Vice Chair Jun 28, 2016
Douglas Cyr Individual Corporate DirectorBoard Member Jan 1, 2020
Alain Bois Individual Corporate OfficerCoo Mar 29, 2021
W-2 Managing EmployeeCoo Mar 29, 2021
James V Harris Individual Corporate DirectorBoard Member Jun 20, 2023
Steven Pelletier Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 129

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1285487330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 E MAIN ST",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431428",
            "telephone_number": "207-834-1850",
            "fax_number": "207-834-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MAIN ST",
            "city": "MADAWASKA",
            "state": "ME",
            "postal_code": "047561088",
            "telephone_number": "207-728-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "ZEWE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-834-1411"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madawaska, ME

Sources for this page

Verify at the official NPI Registry.