NPIMap

Individual provider Active NPI

Liia Edouardovna Doumanovskaia, M.D.

  • Internal Medicine Physician
  • Fort Kent, ME
National Provider Identifier
1366739930
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
018838 Issued in ME
Practice address
194 E Main St
Fort Kent, ME 04743-1428
Phone
(207) 834-1581
Fax
(207) 834-2949
NPI assigned
Jul 5, 2011
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 018838 ME Primary

Addresses

Primary practice location

194 E Main St
Fort Kent, ME 04743-1428

Mailing address

12 High St Ste 400
Lewiston, ME 04240-7690
Phone (207) 795-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110818000107 ME Practitioner - Internal Medicine 0547439002 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
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)

111 Franklin CMNS
Farmington, ME 04938
Phone (207) 778-6031

111 Franklin Health CMNS
Farmington, ME 04938-6144
Phone (207) 779-3113

181 Franklin Health CMNS
Farmington, ME 04938-6144

22 Bramhall St
Portland, ME 04102-3134

Hospital & facility affiliations

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
018838MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 6, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Dec 1, 2018 Accepting new patients
Northern Maine Medical Center CurrentSince Jul 20, 2011 Accepting new patients
Mainehealth CurrentSince Jan 6, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Dec 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Northern Maine Medical Center CurrentSince Jul 20, 2011 Accepting new patients

Locations

181 Franklin Health Cmns
Farmington, ME 04938
Phone (207) 778-3326

194 E Main St
Fort Kent, ME 04743
Phone (207) 834-3101

12 High St
Ste 400
Lewiston, ME 04240
Phone (207) 795-5700

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: ldoumanovs@yourcarecommunity.org
  • Direct secure messaging: ldoumanovskaia564317@direct.mmc.mainehealth.org

Organizations & group practices 8

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": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1366739930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST STE 400",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407690",
            "telephone_number": "207-795-5700",
            "fax_number": "207-795-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 E MAIN ST",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431428",
            "telephone_number": "207-834-1581",
            "fax_number": "207-834-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUMANOVSKAIA",
        "first_name": "LIIA",
        "middle_name": "EDOUARDOVNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "018838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Kent, ME

Sources for this page

Verify at the official NPI Registry.