Active NPI
Molly Elizabeth Mack, CRNA
- Certified Registered Nurse Anesthetist
- Portland, ME
National Provider Identifier
1477353431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RNA253037
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-2526
- Fax
- (207) 662-6236
- NPI assigned
- Mar 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 187689 | CT | |
| Certified Registered Nurse Anesthetist | 367500000X | RNA253037 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2526
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Other practice location 2
84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000
Other practice location 3
1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7042
Other practice location 4
25 June St
Sanford, ME 04073-2621
Phone (207) 490-7450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 187689 | CT | MD | Registered Nurse |
| RNA253037 | ME | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
25 June St
Sanford, ME 04073
Phone (207) 324-4310
84 Campus Dr
Scarborough, ME 04074
Phone (207) 396-7000
Organizations & group practices 3
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Multi-Specialty Clinic/Center
- Biddeford, ME
- NPI 1215417019
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1477353431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2526",
"fax_number": "207-662-6236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2526",
"fax_number": "207-662-6236"
}
],
"practiceLocations": [
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4242",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "84 Campus Dr",
"address_purpose": "LOCATION",
"city": "Scarborough",
"state": "ME",
"postal_code": "040747133",
"country_code": "US",
"telephone_number": "207-396-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Biddeford",
"state": "ME",
"postal_code": "040059422",
"country_code": "US",
"telephone_number": "207-283-7042",
"fax_number": "207-283-7047",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "25 June St",
"address_purpose": "LOCATION",
"city": "Sanford",
"state": "ME",
"postal_code": "040732621",
"country_code": "US",
"telephone_number": "207-490-7450",
"fax_number": "207-490-7452",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACK",
"first_name": "MOLLY",
"middle_name": "ELIZABETH",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-18",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "187689",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ME",
"license": "RNA253037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.