NPIMap

Organization Active NPI

Maine Eye Center, PA

  • Ambulatory Surgical Clinic/Center
  • Portland, ME
National Provider Identifier
1295855948
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
36641 Issued in ME
Legal business name
MAINE EYE CENTER, PA
Practice address
161 Marginal Way
Portland, ME 04101-2438
Phone
(207) 774-8277
Fax
(207) 699-5850
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Judith McCann
Title
Director of Revenue Cycle
Phone
(848) 219-2109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 36641 ME Primary

Addresses

Primary practice location

161 Marginal Way
Portland, ME 04101-2438

Mailing address

15 Lowell St
Portland, ME 04102-2726
Phone (207) 774-8277

Other identifiers 4

IdentifierTypeStateIssuer
106700300MedicaidME
M187212OtherMECIGNA HS FACILITY GROUP
000335OtherMEANTHEM FACILITY GROUP
2359120OtherMEAETNA FACILITY GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000183 ME Part B Supplier - Ambulatory Surgical Center 0446240634 Receives reassigned benefits from 7 practitioners
Practice locations: Portland, ME

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Maine Eye Center PACCN 20C0001000
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D2137914Maine Eye Center PA161 Marginal Way, Portland, ME 04101Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1295855948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022726",
            "telephone_number": "207-774-8277",
            "fax_number": "207-699-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-774-8277",
            "fax_number": "207-699-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE EYE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "848-219-2109"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ME",
            "license": "36641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106700300",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HS FACILITY GROUP",
            "identifier": "M187212",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FACILITY GROUP",
            "identifier": "000335",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FACILITY GROUP",
            "identifier": "2359120",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.