Maine Molecular Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAINE MOLECULAR IMAGING LLC

Practice address

100 Campus Dr
Scarborough, ME 04074-9692

Phone

(800) 734-4132

Fax

(800) 273-2377

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Brian G Drazba

Title

Senior V.P. & Chief Accounting Ofcr

Phone

(949) 282-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Skowhegan, ME
  • NPI 1316995632

  O20041230000236

  Same enrollment
• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Waterville, ME
  • NPI 1750339065

  O20041230000236

  Same enrollment
• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Lewiston, ME
  • NPI 1972551299

  O20041230000236

  Same enrollment

Member of 2

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

• Mainehealth

  • Pediatrics Physician
  • Falmouth, ME
  • NPI 1629382601

  Member Of

  NPD member
• Insight Health Corp

  • Diagnostic Radiology Physician
  • Woodbridge, VA
  • NPI 1255300471

  Member Of

  NPD member

Practitioners 3

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

• Michael D Digianvittorio, DO

  • Diagnostic Radiology Physician
  • Portland, ME
  • NPI 1568781789
  NPD
• Daniel G Kloda, D.O.

  • Vascular & Interventional Radiology Physician
  • Portland, ME
  • NPI 1558432674
  NPD
• Michael O'Malley Quinn, M.D.

  • Diagnostic Radiology Physician
  • Portland, ME
  • NPI 1033281712
  NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1316995624",
    "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": "100 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749692",
            "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": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "DRAZBA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR V.P. & CHIEF ACCOUNTING OFCR",
        "authorized_official_telephone_number": "949-282-6000"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "626446",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BLUE SH",
            "identifier": "041536",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maine Medical Partners
• Maine Medical Partners
• Maine Medical Partners
• Maine Medical Partners
• Maine Medical Partners
• Maine Neurology, P.a.
• Maine Neurology, PA
• Maine Rehabilitative Healthcare, LLC
• Maine Spine & Nerve Institute
• Maine Veterans' Home

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.