NPIMap

Individual provider Active NPI

Megan R Waterman, MD

  • Family Medicine Physician
  • Portland, ME
National Provider Identifier
1477997146
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD21755 Issued in ME
Practice address
180 Park Ave Ste 1
Portland, ME 04102-2927
Phone
(207) 874-2141
Fax
(207) 874-2164
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125063557 IL
Family Medicine Physician 207Q00000X MD21755 ME Primary

Addresses

Primary practice location

180 Park Ave Ste 1
Portland, ME 04102-2927

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

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
I20171204000235 ME Practitioner - Family Practice 5890095020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Community Health CenterGroup PAC ID 5395998017, 37 clinicians

Practice addresses (Care Compare)

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

295 Park Ave
Portland, ME 04102-2911
Phone (207) 874-2141

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21755MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Community Health Center Current Accepting new patients
Portland Community Health Center CurrentSince Sep 27, 2017 Accepting new patients
Portland Community Health Center CurrentSince Sep 27, 2017 Accepting new patients

Locations

180 Park Ave
Portland, ME 04102
Phone (207) 772-3703

180 Park Ave
Ste 1
Portland, ME 04102
Phone (207) 828-2101

Interoperability endpoints

  • Direct secure messaging: megan.waterman.p1@direct.portlandchc.nextgenshare.com

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.

Hospital & facility affiliations 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1477997146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141",
            "fax_number": "207-761-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022927",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "MEGAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125063557",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD21755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.