Maine Molecular Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAINE MOLECULAR IMAGING LLC

Practice address

123 Medical Center Dr
Brunswick, ME 04011-2652

Phone

(800) 734-4132

Fax

(800) 273-2377

NPI assigned

May 5, 2006

Last updated

Aug 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ramona L Ahern

Title

Special Assistant Secretary

Phone

(952) 738-4441

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Biddeford, ME
  • NPI 1548219579

  5294793782

  Same PAC ID
• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Lewiston, ME
  • NPI 1972551299

  5294793782

  Same PAC ID
• Maine Molecular Imaging, LLC

  dba Maine Molecular Imaging

  • Diagnostic Radiology Physician
  • Rockport, ME
  • NPI 1184161085

  5294793782

  Same PAC ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Mainehealth

  dba MaineHealth Waldo Hospital

  • Critical Access Hospital
  • Belfast, ME
  • NPI 1841397932

  Member Of

  NPD member
• Insight Health Corp

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Woodbridge, VA
  • NPI 1255300471

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith W Fleming, MD

  • Diagnostic Radiology Physician
  • Brunswick, ME
  • NPI 1417063355
  NPD
• Maureen Magut Charette, MD

  • Diagnostic Radiology Physician
  • Bar Harbor, ME
  • NPI 1205812476
  NPD
• Thomas D Cesca, MD

  • Diagnostic Radiology Physician
  • Fort Collins, CO
  • NPI 1992144976
  NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1285682591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414025",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414025",
            "telephone_number": "949-282-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112652",
            "telephone_number": "800-734-4132",
            "fax_number": "800-273-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MOLECULAR IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SPECIAL ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "952-738-4441"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "470001736",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170500000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maine Coast Rheumatology PLLC
• Maine Feldenkrais & Physical Therapy
• Maine Geropsychology, LLC
• Maine Interventional, LLC
• Maine Mobile Dental Hygiene LLC
• Maine Mother and Company LLC
• Maine Street Medical PLLC
• Mainehealth (MaineHealth Primary Care Family Medicine)
• Mainehealth (MaineHealth Ophthalmology)
• Mainehealth (Mainehealth Behavioral Health)

• Physiological Laboratory in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Physiological Laboratory in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.