Mainehealth
Organization Active NPI Neurology Physician · Scarborough, ME
NPI 1497052518 · NPPES record last updated Dec 19, 2022
Key facts
- NPI
- 1497052518
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- MAINEHEALTH
- Practice address
- 49 Spring St
2ND Floor
Scarborough, ME 04074 - Phone
- (207) 883-1414
- Fax
- (207) 883-1010
- NPI assigned
- Feb 25, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- MAINEHEALTH
Authorized official
- Name
- Lugene Anthony Inzana
- Title
- Asscoaite Cfo
- Phone
- (207) 662-3538
Owners & managing parties with NPI records 5
-
Lisa T Beaule, MD
-
Brett M Loffredo, MD
-
Peter C Manning, MD
-
Thomas J Ryan Jr., M.D.
Other NPIs on the same Medicare enrollment 51
Related certifications (CCN) 1
Practitioners 73
-
Lucy C. Andrade, NP
-
Gemma Sarah Atticks, LCSW
-
Shannon M. Bennett, D.O.
-
Megan O Bridgeo, P.A.
-
Alixandra Nicole Buckvar, LCSW
-
Shahin Peirce Carter, PA-C
-
Scott M Chase, D.O.
-
Helen Mary Cohen, WHNP
-
Sarah Couture, PA
-
Nicholas P Cullen, LCSW
-
Rana R Daniel, DO
-
Madeline Dinardo, APRN-CRNA
-
Linda S. Durst, MD
-
Kaitlin J Dyer, FNP
-
Ben Jacob Guido, MD
-
Matthew P Guilbeault, PA-C
-
Daniel P Hammond, D.O.
-
Beth Hartsock, NP
Affiliated clinicians 2,518
-
George E Abboud, MD
-
Ahmad Abed Elnoor, M.D.
-
Joselyn M Abernethy, MSN, ACNP-BC
-
Philip Abraham, M.D.
-
Joshua Abrams, PA-C
-
Haley Estabrook Acker, PA-C
-
Niall Adams, MB BCH BAO
-
Todd M Adams, MD
-
Virginia JS Adams, CRNA
-
Katharine E Addicott, FNP
-
Gregory S Adey, M.D.
-
Mary Elizabeth Adorisio, PA-C
-
Maxwell Afari, MD
-
Mats Agren, M.D.
-
Bilal R Ahmad, M.D.
Medicare Care Compare: Hospital
- Listed as
- Mainehealth Maine Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ME
Hospital certification: CCN 200009
- Legal name
- MAINEHEALTH
- Doing business as
- MAINEHEALTH MAINE MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Feb 27, 2019
- Beds
- 606
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 22 Bramhall St
Portland, ME 41023134 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 33
| Name | Role | Since | Share |
|---|---|---|---|
| Nancy a Hasenfus |
Corporate Director | Jan 1, 2019 | |
| Brett Loffredo |
Corporate Director | Jan 1, 2019 | |
| Brian H Noyes |
Corporate Director |
Oct 1, 2016 | |
| Dawn M Tutt |
W-2 Managing Employee |
Dec 30, 2013 | |
| Marie J McCarthy |
Corporate Director |
Oct 1, 2016 | |
| Matthew Chin |
Corporate Director | Apr 1, 2025 | |
| Katherine B Coster |
Corporate Director |
Oct 1, 2016 | |
| Beth Kelsch |
Corporate Officer |
Apr 1, 2025 | |
| Robert Hunter |
Corporate Officer |
Dec 1, 2025 | |
| Ann W Bresnahan |
Corporate Director |
Oct 1, 2023 | |
| Christopher Cimino |
Corporate Director | Oct 1, 2025 | |
| Andrew T Mueller |
Corporate Officer |
Jul 1, 2021 | |
| Lisa T Beaule |
Corporate Director | Jan 1, 2019 | |
| Charles Richard Bayman |
Corporate Officer |
Dec 1, 2025 | |
| Corporate Director |
Dec 1, 2025 | ||
| Christopher C Coon |
Corporate Officer |
Jan 1, 2016 | |
| Kelly a Elkins |
Corporate Officer | Jan 1, 2022 | |
| Jennifer Kent |
Corporate Director | Oct 1, 2025 | |
| Peter W Wood |
Corporate Director | Jan 1, 2022 | |
| Thomas J Ryan |
Corporate Director | Jan 1, 2019 | |
| David J Kumaki |
Corporate Director | Jan 1, 2019 | |
| Quincy Hentzel |
Corporate Director | Apr 1, 2025 | |
| Morris L Fisher |
Corporate Director |
Jun 1, 2013 | |
| Leslie Clinton Boothby |
Corporate Director | Jan 1, 2019 | |
| Kathleen Herlihy |
Corporate Director | Jan 1, 2019 | |
| Mainehealth Services |
5% Or Greater Direct Ownership Interest | Jan 1, 2019 | 100% |
| Operational/Managerial Control | Jan 1, 2019 | 100% | |
| Linda M. Terry |
Corporate Director | Jan 1, 2022 | |
| Peter C Manning |
Corporate Director | Jan 1, 2019 | |
| Alissa Chasse |
W-2 Managing Employee |
Jan 1, 2025 | |
| Daniel L Loiselle |
Corporate Director | Jan 1, 2019 | |
| Kelly Champney |
Corporate Officer |
Jun 1, 2026 | |
| Matthew P Orlando |
Corporate Director |
Oct 1, 2024 | |
| Stuart H Watson |
Corporate Director | Jan 1, 2022 | |
| Amanda Rand |
Corporate Director | Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040701000166 | ME | Part B Supplier - Clinic/Group Practice | 7517860588 |
Receives reassigned benefits from 3,561 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20071116000569 | ME | Part a Provider - Hospital | 7517860588 |
35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Maine Medical Assoc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | Yes | ||
| Neurology with Special Qualifications in Child Neurology Physician |
2084N0402X | |||
| Clinical Neurophysiology Physician |
2084N0600X | |||
| Pain Medicine (Psychiatry & Neurology) Physician |
2084P2900X | |||
| Vascular Neurology Physician |
2084V0102X | |||
| Magnetic Resonance Imaging Radiologic Technologist |
2471M1202X | |||
| General Acute Care Hospital | 282N00000X | 37563 | ME | |
| Adult Health Nurse Practitioner |
363LA2200X | |||
| Family Nurse Practitioner |
363LF0000X | |||
| Pediatric Nurse Practitioner |
363LP0200X |
Addresses
Primary practice location
49 Spring St
2ND Floor
Scarborough, ME 04074
Mailing address
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-6562
Other names
- Maine Medical Partners Neurology
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Scarborough, ME
- Maine Veterans' Home
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All providers in Scarborough, ME · Neurology Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.