NPIMap

Individual provider Active NPI

Anuj Mediratta, M.D.

  • Cardiovascular Disease Physician
  • Scarborough, ME
National Provider Identifier
1457508574
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA10363400 Issued in NJ
Practice address
96 Campus Dr
Scarborough, ME 04074-7163
Phone
(207) 885-9905
Fax
(207) 396-5600
NPI assigned
Aug 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AN52403945894 IL
Cardiovascular Disease Physician 207RC0000X 25MA10363400 NJ Primary
Cardiovascular Disease Physician 207RC0000X 24183 NH
Cardiovascular Disease Physician 207RC0000X MD26046 ME

Addresses

Primary practice location

96 Campus Dr
Scarborough, ME 04074-7163

Mailing address

96 Campus Dr
Scarborough, ME 04074-7163
Phone (207) 885-9905

Other practice location 1

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-4835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, ME, NH3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180815000688 NJ Practitioner - Cardiovascular Disease (Cardiology) 4587842588
I20230630000093 ME Practitioner - Cardiovascular Disease (Cardiology) 4587842588 Reassigns benefits to 3 organizations
I20240215003891 NH Practitioner - Cardiovascular Disease (Cardiology) 4587842588

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

96 Campus Dr
Scarborough, ME 04074-7163
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315
  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008
  • Redington Fairview General Hospital Hospital, Skowhegan, ME, CCN 201314

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AN52403945894ILMDInternal Medicine Physician
25MA10363400NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jul 10, 2023 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Mar 26, 2024 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Mar 26, 2024 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners Cardiovascular Disease CurrentSince Jul 10, 2023 Accepting new patients
Mainehealth CurrentSince Jul 10, 2023 Accepting new patients
Mainehealth CurrentSince Jul 10, 2023 Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

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

96 Campus Dr
Scarborough, ME 04074
Phone (207) 885-9905

96 Campus Dr
Ste 1
Scarborough, ME 04074
Phone (207) 396-5611

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: amediratta591769@direct.mmc.mainehealth.org

Organizations & group practices 9

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1457508574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3073 White Mountain Hwy",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038607101",
            "country_code": "US",
            "telephone_number": "603-356-4835",
            "fax_number": "603-356-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDIRATTA",
        "first_name": "ANUJ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "AN52403945894",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA10363400",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "24183",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD26046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.