NPIMap

Individual provider Active NPI

Fred E Emerson, MD

  • Internal Medicine Physician
  • Windham, ME
National Provider Identifier
1487722278
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18052 Issued in ME
Practice address
584 Roosevelt Trail
Windham, ME 04062-4904
Phone
(207) 892-3233
Fax
(207) 893-0752
NPI assigned
Dec 1, 2006
Last updated
Jun 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD18052 ME Primary
Pediatrics Physician 208000000X MD18052 ME

Addresses

Primary practice location

584 Roosevelt Trail
Windham, ME 04062-4904

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other identifiers 2

IdentifierTypeStateIssuer
30208517MedicaidNH
433831099MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090713000107 ME Practitioner - Pediatric MedicinePractitioner - Internal Medicine 7113079799 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Albany Medical College of Union University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

582 Roosevelt TRL
Windham, ME 04062-4904
Phone (207) 892-3233

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD18052MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2010 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Apr 1, 2012 Accepting new patients
Maine Medical Partners Internal Medicine CurrentSince Jul 1, 2009 Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2009 Accepting new patients
Maine Medical Partners CurrentSince Apr 1, 2012 Accepting new patients
Maine Medical Partners Internal Medicine Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2010 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Apr 1, 2012 Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

582 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3233

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: femerson729@direct.mmc.mainehealth.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1487722278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 ROOSEVELT TRAIL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040624904",
            "telephone_number": "207-892-3233",
            "fax_number": "207-893-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "FRED",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD18052",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD18052",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30208517",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433831099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

Verify at the official NPI Registry.