NPIMap

Individual provider Active NPI

Melissa Ifantides, DO

  • Family Medicine Physician
  • Sanford, ME
National Provider Identifier
1407992175
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1976 Issued in ME
Practice address
25A June St
Suite 101
Sanford, ME 04073-2642
Phone
(207) 490-7998
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO1976 ME Primary

Addresses

Primary practice location

25A June St
Suite 101
Sanford, ME 04073-2642

Mailing address

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7000

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
I20070808000612 ME Practitioner - Family Practice 0840381646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

25 A June St
Sanford, ME 04073-2642

Hospital & facility affiliations

  • Wentworth Home Care & Hospice, an Amedisys Partner Home health agency, Somersworth, NH, CCN 307014
  • Mainehealth Home Health and Hospice Home health agency, Saco, ME, CCN 207000
  • Elara Caring Home health agency, South Portland, ME, CCN 207080
  • Andwell Health Partners Hospice, Scarborough, ME, CCN 201511
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1976MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Webber Hospital Association CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Family Medicine Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

3 Shape Dr
Kennebunk, ME 04043
Phone (207) 467-8930

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

25A June St
Ste 101
Sanford, ME 04073
Phone (207) 490-7998

25A June St
Ste 111
Sanford, ME 04073
Phone (207) 324-5968

25 June St
Sanford, ME 04073
Phone (207) 324-4310

Interoperability endpoints

  • Direct secure messaging: mifantides156942@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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1407992175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-283-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25A JUNE ST",
            "address_2": "SUITE 101",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732642",
            "telephone_number": "207-490-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFANTIDES",
        "first_name": "MELISSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO1976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

Verify at the official NPI Registry.