Active NPI
K. Erik Kostelnik, M.D.
- Dermatology Physician
- Portland, ME
National Provider Identifier
1346289683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 014713
- Practice address
- 50 Sewall St
Portland, ME 04102-2624 - Phone
- (207) 775-3526
- Fax
- (207) 775-5658
- NPI assigned
- Jun 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 014713 | ME | Primary |
Addresses
Primary practice location
50 Sewall St
Portland, ME 04102-2624
Mailing address
50 Sewall St
Portland, ME 04102-2624
Phone (207) 775-3526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431499999 | Medicaid | ME |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Jefferson Medical College of Thomas Jefferson University, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
50 Sewall St
Portland, ME 04102-2691
Phone 2077753526212
Hospital & facility affiliations
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 910 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 188 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014713 | ME | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Associates, LLC | Dermatology | Current | Accepting new patients |
Locations
57 Barra Rd
Biddeford, ME 04005
Phone (207) 282-1305
2 Admiral Fitch Ave
Ste B
Brunswick, ME 04011
295 Park Ave
Portland, ME 04102
Phone (207) 662-2004
50 Sewall St
Portland, ME 04102
Phone (207) 775-3526
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.
-
- Dermatology Physician
- Portland, ME
- NPI 1780635342
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1346289683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 SEWALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022624",
"telephone_number": "207-775-3526",
"fax_number": "207-775-5658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 SEWALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022624",
"telephone_number": "207-775-3526",
"fax_number": "207-775-5658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTELNIK",
"first_name": "K. ERIK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "ME",
"license": "014713",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "431499999",
"state": "ME"
}
],
"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 Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.