NPIMap

Organization Active NPI

Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Belfast, ME
National Provider Identifier
1487438164
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CONVENIENTMD - FFS UC LLC
Practice address
18 Belmont Ave
Belfast, ME 04915
Phone
(207) 607-5270
NPI assigned
Aug 23, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Jarod Boissonneault
Title
VP, Revenue Cycle MGT
Phone
(603) 319-6223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

18 Belmont Ave
Belfast, ME 04915

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230803000124 ME Part B Supplier - Clinic/Group Practice 5193186492 Receives reassigned benefits from 167 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, ME; Westbrook, ME; Sanford, ME; Saco, ME; Farmington, ME; Ellsworth, ME; Brunswick, ME; Belfast, ME…

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Tax ID family
Convenientmd - FFS UC LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

35 Storey Ave
Newburyport, MA 01950
Phone (978) 225-6607

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

543 Broadway
Bangor, ME 04401
Phone (207) 907-1300

77 Daniel Webster Hwy
Belmont, NH 03220
Phone (603) 737-0500

360 Route 1 Byp
Unit 2
Portsmouth, NH 03801

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1487438164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 BELMONT AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "207-607-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENTMD - FFS UC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "BOISSONNEAULT",
        "authorized_official_first_name": "JAROD",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE MGT",
        "authorized_official_telephone_number": "603-319-6223"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.