Individual provider Active NPI

Janie Dao Nguyen, D.O.

  • Anesthesiology Physician
  • Portland, ME
National Provider Identifier
1407268535
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
DO2788 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102
Phone
(207) 662-0111
NPI assigned
May 23, 2014
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DO2788 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-0111

Other practice location 1

324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800

Other identifiers 1

IdentifierTypeStateIssuer
14707268535MedicaidME

Other names 1

  • Miss Anh Dao Thi Nguyen Other name

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
I20180723000672 ME Practitioner - Anesthesiology 3476779307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Western University of Health Sciences College of Dental Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Anesthesia Associates PAGroup PAC ID 8325027428, 36 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901-4974
Phone (207) 622-1959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2788MEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Anesthesia Associates, P.a. Anesthesiology CurrentSince Feb 5, 2021 Accepting new patients

Locations

35 Medical Center Pkwy
#201
Augusta, ME 04330
Phone (207) 622-1959

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

35 Medical Center Pkwy
Ste 201
Augusta, ME 04330
Phone (207) 620-1136

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 1

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1407268535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 Gannett Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041063266",
            "country_code": "US",
            "telephone_number": "207-482-7800",
            "fax_number": "207-956-6676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JANIE",
        "middle_name": "DAO",
        "name_prefix": "Miss",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "DO2788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14707268535",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANH DAO",
            "last_name": "NGUYEN",
            "middle_name": "THI",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.