Individual provider Active NPI

Benjamin Bruce Mailloux, MD

  • Family Medicine Physician
  • Belfast, ME
National Provider Identifier
1366545972
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
018083 Issued in ME
Practice address
16 Fahey St
Suite 103
Belfast, ME 04915
Phone
(207) 338-5440
Fax
(207) 338-6912
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 018083 ME Primary

Addresses

Primary practice location

16 Fahey St
Suite 103
Belfast, ME 04915

Mailing address

16 Fahey St
Suite 103
Belfast, ME 04915
Phone (207) 338-5440

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
I20091006000477 ME Practitioner - Family Practice 1254333958 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 2005
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)

119 Northport Ave FL
1 WCMP Primary Care
Belfast, ME 04915-6069
Phone (207) 930-6708

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Home Health and Hospice Home health agency, Saco, ME, CCN 207000
  • Amedisys Home Health Home health agency, Bangor, ME, CCN 207075
  • Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

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
018083MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 24, 2009 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth Family Medicine Past Accepting new patients

Locations

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

119 Northport Ave
Fl 1
Belfast, ME 04915
Phone (207) 505-4567

116 Northport Ave
Ste 220
Belfast, ME 04915
Phone (207) 505-4015

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

Interoperability endpoints

  • Direct secure messaging: bmailloux101153@direct.mmc.mainehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1366545972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FAHEY ST",
            "address_2": "SUITE 103",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "207-338-5440",
            "fax_number": "207-338-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FAHEY ST",
            "address_2": "SUITE 103",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "207-338-5440",
            "fax_number": "207-338-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLOUX",
        "first_name": "BENJAMIN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "018083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, ME

Sources for this page

Verify at the official NPI Registry.