NPIMap

Organization Active NPI

Mainehealth

Doing business as MaineHealth Medical Group-Primary Care

  • Clinic/Center
  • Portland, ME
National Provider Identifier
1487346722
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MAINEHEALTH
Doing business as
MaineHealth Medical Group-Primary Care
Practice address
110 Free St
Portland, ME 04101-3908
Phone
(207) 661-7001
NPI assigned
May 24, 2023
Last updated
May 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MAINEHEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Mr. Lugene A Inzana
Title
Associate Cfo
Phone
(207) 661-1346

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X
Family Medicine Physician 207Q00000X
Geriatric Medicine (Family Medicine) Physician 207QG0300X
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Pediatrics Physician 208000000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

110 Free St
Portland, ME 04101-3908

Mailing address

PO Box 360489
Pittsburgh, PA 15251-6489
Phone (207) 887-5100

Other names 1

  • MaineHealth Medical Group-Primary Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701000166 ME Part B Supplier - Clinic/Group Practice 7517860588 Receives reassigned benefits from 3,561 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory
Part of
Mainehealth

Locations

66 Bramhall St
Fl 1
Portland, ME 04102
Phone (207) 662-3101

25A June St
Ste 011
Sanford, ME 04073
Phone (207) 282-5509

Practitioners & affiliated clinicians

Practitioners 1,051

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,051

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1487346722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360489",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516489",
            "telephone_number": "207-887-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FREE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013908",
            "telephone_number": "207-661-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAINEHEALTH",
        "enumeration_date": "2023-05-24",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "INZANA",
        "authorized_official_first_name": "LUGENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASSOCIATE CFO",
        "authorized_official_telephone_number": "207-661-1346",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MaineHealth Medical Group-Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MaineHealth Medical Group-Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.