Individual provider Active NPI

Julie E Pelletier, MD

  • Emergency Medicine Physician
  • South Portland, ME
National Provider Identifier
1336469063
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD19367 Issued in ME
Practice address
50 Foden Rd Ste 3
South Portland, ME 04106-1718
Phone
(207) 523-3700
Fax
(207) 523-8590
NPI assigned
Jun 4, 2010
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD19367 ME Primary

Addresses

Primary practice location

50 Foden Rd Ste 3
South Portland, ME 04106-1718

Mailing address

100 Gannett Dr Ste C
South Portland, ME 04106-5900
Phone (207) 828-0361

Other practice location 1

118 Northport Ave
Belfast, ME 04915-6009
Phone (207) 505-4123

Other practice location 2

35 Miles St
Damariscotta, ME 04543-4047
Phone (207) 563-4521

Other practice location 3

91 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8120

Other practice location 4

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 921-8311

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
I20130207000060 ME Practitioner - Emergency Medicine 9032363627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Diego School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

35 Mile St
Damariscotta, ME 04543-4047
Phone (207) 563-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19367MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 20, 2020 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Sep 6, 2016 Accepting new patients
St. Mary's Regional Medical Center Current Accepting new patients
Mainehealth CurrentSince Jun 20, 2020 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
St. Mary's Regional Medical Center CurrentSince Sep 6, 2016 Accepting new patients
Mainehealth Past Accepting new patients

Locations

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

181 Main St
Norway, ME 04268
Phone (207) 743-5933

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

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

Interoperability endpoints

  • Direct secure messaging: jpelletier31316@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1336469063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FODEN RD STE 3",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061718",
            "telephone_number": "207-523-3700",
            "fax_number": "207-523-8590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Northport Ave",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156009",
            "country_code": "US",
            "telephone_number": "207-505-4123",
            "fax_number": "207-338-6820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Miles St",
            "address_purpose": "LOCATION",
            "city": "Damariscotta",
            "state": "ME",
            "postal_code": "045434047",
            "country_code": "US",
            "telephone_number": "207-563-4521",
            "fax_number": "207-810-4989",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "91 Campus Ave",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042406030",
            "country_code": "US",
            "telephone_number": "207-777-8120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Glen Cove Dr",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "048564272",
            "country_code": "US",
            "telephone_number": "207-921-8311",
            "fax_number": "207-301-5288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JULIE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD19367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.