Individual provider Active NPI

Stefanie J Chin, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, ME
National Provider Identifier
1407025315
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R034459 Issued in ME
Practice address
144 State St
Portland, ME 04101-3776
Phone
(207) 879-3000
NPI assigned
Feb 25, 2008
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R034459 ME Primary

Addresses

Primary practice location

144 State St
Portland, ME 04101-3776

Mailing address

144 State St
Portland, ME 04101-3776
Phone (207) 879-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000063 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527126309 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R034459MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Anesthesia Partners LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 9, 2024 Accepting new patients
Intermed, PA CurrentSince Mar 27, 2023 Accepting new patients
Mercy Hospital CurrentSince Jan 24, 2008 Accepting new patients
Intermed, PA CurrentSince Mar 27, 2023 Accepting new patients
Mercy Hospital CurrentSince Jan 24, 2008 Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

53 Sewall St
Portland, ME 04102
Phone (207) 350-5019

100 Foden Rd
Ste W-100
South Portland, ME 04106
Phone (207) 523-3900

100 Gannett Dr
Ste C
South Portland, ME 04106
Phone (207) 523-3649

405 Western Ave
South Portland, ME 04106
Phone (207) 272-0707

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1407025315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "STEFANIE",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "R034459",
            "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 Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.