Active NPI
Dylan T Ouellette, CRNA
- Certified Registered Nurse Anesthetist
- Portland, ME
National Provider Identifier
1316439714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RNA203062
- Practice address
- 175 Fore River Pkwy
Portland, ME 04102-2779 - Phone
- (207) 879-3000
- NPI assigned
- May 31, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | RNA203062 | ME | Primary |
Addresses
Primary practice location
175 Fore River Pkwy
Portland, ME 04102-2779
Mailing address
PO Box 441
Caribou, ME 04736-0441
Phone (207) 551-5699
Other practice location 1
140 Academy St
Presque Isle, ME 04769-3102
Phone (207) 768-4000
Other practice location 2
716 Stevens Ave
Portland, ME 04103-2693
Phone (207) 283-0171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
163 Van Buren Rd
Suite 1
Caribou, ME 04736-3567
Phone (207) 498-3111
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.67 of 100
- Quality
- 60.7
- Promoting interoperability
- 91
- Improvement activities
- 40
- Cost
- 73.8
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Caribou | Current | Accepting new patients | |
| Mercy Hospital | Past | Accepting new patients |
Locations
163 Van Buren Rd
Ste 1
Caribou, ME 04736
Phone (207) 498-1227
Organizations & group practices 3
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.
-
dba Northern Light A.R. Gould Hospital
- General Acute Care Hospital
- Presque Isle, ME
- NPI 1396858999
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1316439714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 441",
"city": "CARIBOU",
"state": "ME",
"postal_code": "047360441",
"telephone_number": "207-551-5699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 FORE RIVER PKWY",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022779",
"telephone_number": "207-879-3000"
}
],
"practiceLocations": [
{
"address_1": "140 Academy St",
"address_purpose": "LOCATION",
"city": "Presque Isle",
"state": "ME",
"postal_code": "047693102",
"country_code": "US",
"telephone_number": "207-768-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "716 Stevens Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041032693",
"country_code": "US",
"telephone_number": "207-283-0171",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OUELLETTE",
"first_name": "DYLAN",
"middle_name": "T",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-31",
"last_updated": "2022-12-13",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ME",
"license": "RNA203062",
"primary": true
}
],
"identifiers": [],
"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 Dec 13, 2022; 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.