Individual provider Active NPI

Marta Aglaee Quijano, M.D.

  • Surgery Physician
  • Portland, ME
National Provider Identifier
1386755643
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
017538 Issued in ME
Practice address
195 Fore River Pkwy
Suite 250
Portland, ME 04102-2780
Phone
(207) 553-6800
Fax
(207) 553-6810
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 017538 ME Primary

Addresses

Primary practice location

195 Fore River Pkwy
Suite 250
Portland, ME 04102-2780

Mailing address

144 State St
4TH Floor
Portland, ME 04101-3776
Phone (207) 553-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017538MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1386755643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "address_2": "4TH FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-553-6800",
            "fax_number": "207-553-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022780",
            "telephone_number": "207-553-6800",
            "fax_number": "207-553-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "MARTA",
        "middle_name": "AGLAEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "017538",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.