NPIMap

Individual provider Active NPI

Anita D Kolisch, MD

  • Internal Medicine Physician
  • Ellsworth, ME
National Provider Identifier
1447283981
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18901 Issued in OR
Practice address
32 Resort Way
Ellsworth, ME 04605-1717
Phone
(207) 664-7780
Fax
(207) 664-7723
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD18901 OR Primary

Addresses

Primary practice location

32 Resort Way
Ellsworth, ME 04605-1717

Mailing address

32 Resort Way
Ellsworth, ME 04605-1717
Phone (207) 664-7780

Other identifiers 1

IdentifierTypeStateIssuer
1447283981MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akolisch@direct.emhs.org

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
I20160809000147 ME Practitioner - Internal Medicine 2961405410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

32 Resort Way
Ellsworth Internal Medicine
Ellsworth, ME 04605-1717
Phone (207) 664-7780

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18901ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Blue Hill Memorial Hospital CurrentSince Sep 3, 2019 Accepting new patients
Maine Coast Regional Health Facilities Internal Medicine CurrentSince Jun 30, 2016 Accepting new patients
The Blue Hill Memorial Hospital CurrentSince Sep 3, 2019 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Jun 30, 2016 Accepting new patients

Locations

57 Water St
Blue Hill, ME 04614
Phone (207) 374-3400

43 Whiting Hill Rd
Ste 200
Brewer, ME 04412
Phone (800) 757-3326

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

32 Resort Way
Ellsworth, ME 04605
Phone (207) 664-5480

354 Airport Rd
Stonington, ME 04681
Phone (207) 367-2311

Interoperability endpoints

  • Direct secure messaging: akolisch@direct.emhs.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northern Light Blue Hill Hospital Swing Bed ProgramBlue Hill, ME, CCN 20Z300 Hospital Corporate Director Jul 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 9

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1447283981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051717",
            "telephone_number": "207-664-7780",
            "fax_number": "207-664-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051717",
            "telephone_number": "207-664-7780",
            "fax_number": "207-664-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLISCH",
        "first_name": "ANITA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD18901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447283981",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akolisch@direct.emhs.org",
            "affiliation": "N",
            "address_1": "32 Resort Way",
            "city": "Ellsworth",
            "state": "ME",
            "country_code": "US",
            "postal_code": "046051717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.