Individual provider Active NPI

Chloe Rose Maczuba

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1487493243
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
39 Roberts St Apt 2
Portland, ME 04102-2881
Phone
(603) 339-6637
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

39 Roberts St Apt 2
Portland, ME 04102-2881

Mailing address

39 Roberts St Apt 2
Portland, ME 04102-2881
Phone (603) 339-6637

Other practice location 1

5 Park Ridge Ave
Rye, NH 03870-2021
Phone (603) 339-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1487493243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 ROBERTS ST APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022881",
            "telephone_number": "603-339-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ROBERTS ST APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022881",
            "telephone_number": "603-339-6637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Park Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Rye",
            "state": "NH",
            "postal_code": "038702021",
            "country_code": "US",
            "telephone_number": "603-339-6637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACZUBA",
        "first_name": "CHLOE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "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 May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.