NPIMap

Individual provider Active NPI

Kelly Daylyn Pizzo, M.D.

  • Gastroenterology Physician
  • Portland, ME
National Provider Identifier
1376986513
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD23093 Issued in ME
Practice address
161 Marginal Way
Portland, ME 04101-2438
Phone
(207) 773-7964
Fax
(207) 773-9073
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD23093 ME Primary

Addresses

Primary practice location

161 Marginal Way
Portland, ME 04101-2438

Mailing address

161 Marginal Way
Portland, ME 04101-2438
Phone (207) 773-7964

Other practice location 1

48 Gilman St
Portland, ME 04102-3004
Phone (207) 661-4400

Other names 1

  • Kelly Daylyn Pitts Former name

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
I20190730000385 ME Practitioner - GastroenterologyPractitioner - Internal Medicine 8628207461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Tufts University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Gastroenterology Associates PAGroup PAC ID 5193702967, 22 clinicians

Practice addresses (Care Compare)

161 Marginal Way
Portland, ME 04101-2438
Phone 2077737964232

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

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Upper gastrointestinal (GI) endoscopy for acid reflux96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23093MEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jan 1, 2021 Accepting new patients
Mainehealth Current Accepting new patients
Portland Gastroenterology Associates P.a. Gastroenterology CurrentSince Sep 3, 2019 Accepting new patients
Mainehealth CurrentSince Jan 1, 2021 Accepting new patients
Mainehealth CurrentSince Jan 1, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2021 Accepting new patients
Portland Endoscopy Center Past Accepting new patients

Locations

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

48 Gilman St
Portland, ME 04102
Phone (207) 661-4400

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

Interoperability endpoints

  • Direct secure messaging: kpizzo262236@direct.mmc.mainehealth.org

Organizations & group practices 7

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 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1376986513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Gilman St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023004",
            "country_code": "US",
            "telephone_number": "207-661-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIZZO",
        "first_name": "KELLY",
        "middle_name": "DAYLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD23093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PITTS",
            "middle_name": "DAYLYN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.