Charlotte A Kassab, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

015235 Issued in ME

Practice address

84 Marginal Way
Suite 900
Portland, ME 04101-2443

Phone

(207) 874-2445

Fax

(207) 523-8598

NPI assigned

Mar 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1487623120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN RD W",
            "address_2": "STE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MARGINAL WAY",
            "address_2": "SUITE 900",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012443",
            "telephone_number": "207-874-2445",
            "fax_number": "207-523-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAB",
        "first_name": "CHARLOTTE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": "015235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2646963",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "041321",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324080099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Karlonas, LMSW-CC
• Jonathan W Karol, DO
• Adam Mathew Karpman, D.O.
• Charm Tharanga Karunasiri, MD
• Timothy Kasper, OTR/L
• Jason Kassir, DMD
• Tomoyo Kasuya, SRNA
• Kate Clark, LCSW
• Kate Lynch DC LLC
• Katherine K. Ryan, PHD, LLC

• Obstetrics & Gynecology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Obstetrics & Gynecology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.