Individual provider Active NPI

Irwin G Brodsky, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Scarborough, ME
National Provider Identifier
1326070905
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD15924 Issued in ME
Practice address
175 US Route 1
Scarborough, ME 04074-9048
Phone
(207) 396-7700
Fax
(207) 396-7701
NPI assigned
Jul 6, 2006
Last updated
Apr 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 MD15924 ME
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD15924 ME Primary

Addresses

Primary practice location

175 US Route 1
Scarborough, ME 04074-9048

Mailing address

190 Riverside St
Suite 6B
Portland, ME 04103-1073
Phone (207) 661-2000

Other identifiers 2

IdentifierTypeStateIssuer
323170099MedicaidME
30208396MedicaidNH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050606000439 ME Practitioner - EndocrinologyPractitioner - Internal Medicine 0143263780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15924MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jul 1, 2002 Accepting new patients
Maine Medical Partners Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2002 Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

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

102 Campus Dr
Unit 116
Scarborough, ME 04074
Phone (207) 883-0069

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

149 North St
Waterville, ME 04901
Phone (207) 622-1959

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

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1326070905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST",
            "address_2": "SUITE 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073",
            "telephone_number": "207-661-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749048",
            "telephone_number": "207-396-7700",
            "fax_number": "207-396-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "IRWIN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD15924",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ME",
            "license": "MD15924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323170099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30208396",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.