Mina Assadollahzadeh, DO
Individual provider Active NPI Family Medicine Physician · Lewiston, ME
NPI 1487068698 · NPPES record last updated Oct 26, 2017
Key facts
- NPI
- 1487068698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO2756 (ME)
- Practice address
- 15 Mollison Way
Lewiston, ME 04240-5805 - Phone
- (207) 777-4440
- Fax
- (207) 783-6660
- NPI assigned
- Jun 16, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 38
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of New England, College of Osteo Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Marys Regional Medical Center
Practice addresses (Care Compare)
15 Mollison Way
Lewiston, ME 04240-5805
Phone (207) 777-4440
Hospital & facility affiliations
- St Mary'S Regional Medical Center
- Central Maine Medical Center
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102001692 | ME | Practitioner - Family Practice | 0941427231 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2756 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Regional Medical Center | Current |
Accepting new patients | |
| St. Mary'S Regional Medical Center | Current |
Accepting new patients |
Locations
15 Mollison Way
Rm A
Lewiston, ME 04240
Phone (207) 777-4440
93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715
15 Mollison Way
Lewiston, ME 04240
Phone (207) 777-4440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO2756 | ME | Yes |
Addresses
Primary practice location
15 Mollison Way
Lewiston, ME 04240-5805
Mailing address
PO Box 1638
Albany, NY 12201-1638
Phone (207) 777-4111
Other providers in Lewiston, ME
- Emma Jo Pray Armington
- Brett Armstrong
- Charles Armstrong
- Nancy Asamoa
- Asli Transportation
- Associated Foot Care PA
- Assurance Residential Services L.L.C
- Jesse Lamar Atwood
- Christine M Audet
- Jesse D. Audet
All providers in Lewiston, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.