Individual provider Active NPI

Wayne A Kruithoff, M.D.

  • Cardiovascular Disease Physician
  • Portland, ME
National Provider Identifier
1447220561
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
015000 Issued in ME
Practice address
144 State St
Portland, ME 04101-3776
Phone
(207) 879-3770
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 015000 ME Primary

Addresses

Primary practice location

144 State St
Portland, ME 04101-3776

Mailing address

144 State St
Portland, ME 04101-3776
Phone (207) 879-3770

Other identifiers 1

IdentifierTypeStateIssuer
275700099MedicaidME

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
I20060322000167 ME Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1153215884 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

144 State St
Portland, ME 04101-3776
Phone (207) 879-3190

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

174 Kennedy Memorial Dr
Waterville, ME 04901-5134
Phone (207) 861-6140

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

19 S Gorham Xing
Gorham, ME 04038-2690
Phone (207) 535-1400

195 Fore River Pkwy
Suite 360
Portland, ME 04102-2786
Phone (207) 553-6868

225 Gorham Rd
Suite 303
South Portland, ME 04106-2462
Phone (207) 535-1880

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

385 Route 1
Yarmouth, ME 04096-6729
Phone (207) 535-1200

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

409 Roosevelt TRL
Windham, ME 04062-4821
Phone (207) 400-8600

43 Baxter Blvd
Suite 2
Portland, ME 04101-1823
Phone (207) 771-1717

75 Gray Rd
Falmouth, ME 04105-2010
Phone (207) 535-1340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

Merit-based Incentive Payment System (MIPS)

Final score
75.94 of 100Reported as group
Quality
47.72
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015000MEMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Jul 1, 2011 Accepting new patients
Mercy Hospital CurrentSince Jul 1, 2011 Accepting new patients
Rumford Hospital CurrentSince Nov 22, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Jun 28, 2016 Accepting new patients
Central Maine Medical Center CurrentSince Jun 28, 2016 Accepting new patients
Rumford Hospital CurrentSince Nov 22, 2023 Accepting new patients
Bridgton Hospital CurrentSince Nov 22, 2023 Accepting new patients
Mercy Hospital Current Accepting new patients
Bridgton Hospital CurrentSince Nov 22, 2023 Accepting new patients
Cardiovascular Consultants of Maine PA Cardiovascular Disease PastSince Feb 12, 2004 Accepting new patients

Locations

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

195 Fore River Pkwy
Ste 460
Portland, ME 04102
Phone (207) 879-3770

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 10

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1447220561",
    "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": "207-879-3770"
        },
        {
            "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": "207-879-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUITHOFF",
        "first_name": "WAYNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "015000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275700099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.