Individual provider Active NPI

Maria J Glad, MS. FNP-BC

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1316345143
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP101081 Issued in ME
Practice address
278 Veranda St
Portland, ME 04103
Phone
(207) 272-3138
NPI assigned
Dec 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X CNP101081 ME
Health Educator 174H00000X CNP101081 ME
Prevention Professional 405300000X CNP101081 ME
Family Nurse Practitioner 363LF0000X CNP101081 ME Primary

Addresses

Primary practice location

278 Veranda St
Portland, ME 04103

Mailing address

260 Western Avenue
B
South Portland, ME 04106-2432
Phone (207) 272-3138

Other names 1

  • Mrs. Maria Glad Rynkowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009000721 ME Practitioner - Nurse Practitioner 6305198045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

278 Veranda St
Portland, ME 04103-5536
Phone (207) 536-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP101081MEMDHealth Educator

Practice roles

OrganizationSpecialtyStatusNew patients
Gladhealth LLC Family CurrentSince Aug 28, 2018 Accepting new patients

Locations

260 Western Ave
#B
South Portland, ME 04106

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1316345143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 WESTERN AVENUE",
            "address_2": "B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062432",
            "telephone_number": "207-272-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 VERANDA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-272-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAD",
        "first_name": "MARIA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MS. FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "ME",
            "license": "CNP101081",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "ME",
            "license": "CNP101081",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "ME",
            "license": "CNP101081",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP101081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "RYNKOWSKI",
            "middle_name": "GLAD",
            "prefix": "MRS.",
            "credential": "MS.FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.