NPIMap

Individual provider Active NPI

Innocent Adrien Ndzana, D.O.

  • Hospitalist Physician
  • Portland, ME
National Provider Identifier
1306223995
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DO3029 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-2179
NPI assigned
May 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO3029 ME
Hospitalist Physician 208M00000X DO3029 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, ME2 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
I20180918001336 PA Practitioner - Internal Medicine 5799086716 Reassigns benefits to 1 organization
I20200823000016 ME Practitioner - Internal MedicinePractitioner - Hospitalist 5799086716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
University of New England, College of Osteo Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO3029MEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 3, 2020 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2018 Accepting new patients
Geisinger Clinic Current Accepting new patients
Maine Medical Partners Internal Medicine CurrentSince Aug 3, 2020 Accepting new patients
Mainehealth CurrentSince Aug 3, 2020 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Aug 3, 2020 Accepting new patients
Mainehealth Past Accepting new patients

Locations

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

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

22 Bramhall St
Rm 2227
Portland, ME 04102
Phone (207) 662-4618

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: indzana103617@direct.mmc.mainehealth.org

Organizations & group practices 9

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1430611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1306223995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDZANA",
        "first_name": "INNOCENT",
        "middle_name": "ADRIEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-03",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "DO3029",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "DO3029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.