Individual provider Active NPI

Mary H. Becker, MD

  • Emergency Medicine Physician
  • South Portland, ME
National Provider Identifier
1447325816
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD13774 Issued in ME
Practice address
50 Foden Rd Ste 3
South Portland, ME 04106-1718
Phone
(207) 523-8500
Fax
(207) 523-8591
NPI assigned
Nov 21, 2006
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD13774 ME Primary
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X MD13774 ME

Addresses

Primary practice location

50 Foden Rd Ste 3
South Portland, ME 04106-1718

Mailing address

100 Gannett Dr Ste C
South Portland, ME 04106-5900
Phone (207) 828-0361

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
I20050721000815 ME Practitioner - Emergency MedicinePractitioner - Hospice/Palliative Care 8729015680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Hospice/Palliative Care
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13774MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 19, 2011 Accepting new patients
Intermed, PA CurrentSince Sep 8, 2022 Accepting new patients
Intermed, PA CurrentSince Sep 8, 2022 Accepting new patients
Mainehealth Emergency Medicine CurrentSince Jan 19, 2011 Accepting new patients
Mainehealth Current Accepting new patients

Locations

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

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

100 Foden Rd
Ste 100
South Portland, ME 04106
Phone (207) 874-1489

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

50 Foden Rd
Ste 3
South Portland, ME 04106
Phone (207) 523-3700

Interoperability endpoints

  • Direct secure messaging: mbecker562@direct.mmc.mainehealth.org

Organizations & group practices 5

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1447325816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FODEN RD STE 3",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061718",
            "telephone_number": "207-523-8500",
            "fax_number": "207-523-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "MARY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD13774",
            "primary": true
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "ME",
            "license": "MD13774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.