Individual provider Active NPI

Annette Haley, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, ME
National Provider Identifier
1487607396
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R038099 Issued in ME
Practice address
144 State St
Portland, ME 04101-3776
Phone
(207) 879-3580
Fax
(207) 879-3353
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R038099 ME Primary

Addresses

Primary practice location

144 State St
Portland, ME 04101-3776

Mailing address

144 State St
Portland, ME 04101-3776
Phone (207) 879-3580

Other identifiers 2

IdentifierTypeStateIssuer
432558399MedicaidME
DC0798OtherMERAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060523000071 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345251716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Engineering, Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R038099MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Dec 8, 2004 Accepting new patients
Mercy Hospital CurrentSince Dec 8, 2004 Accepting new patients
Michael K Taylor, MD, & Jason T Halverson, MD, PLLC Past Accepting new patients
Casco Bay Gastroenterology LLC Past Accepting new patients
Casco Bay Endoscopy Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

931 Union St
Fl 3
Bangor, ME 04401

195 Fore River Pkwy
Ste 490
Portland, ME 04102
Phone (207) 553-6054

25 Long Creek Dr
Ste B
South Portland, ME 04106
Phone (207) 879-0094

25 Long Creek Dr
South Portland, ME 04106
Phone (207) 535-1100

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 6

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1487607396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3580",
            "fax_number": "207-879-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3580",
            "fax_number": "207-879-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "ANNETTE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "R038099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432558399",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC0798",
            "state": "ME"
        }
    ],
    "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 Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.