NPIMap

Organization Active NPI

Mainehealth

  • Family Medicine Physician
  • Scarborough, ME
National Provider Identifier
1497068969
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAINEHEALTH
Practice address
300 Professional Dr
Scarborough, ME 04074
Phone
(207) 883-3491
Fax
(207) 883-5587
NPI assigned
Jul 26, 2010
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MAINE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Lugene Anthony Inzana
Title
SVP Finance/Cfo
Phone
(207) 662-3538

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 37563 ME
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

300 Professional Dr
Scarborough, ME 04074

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-6562

Other names 1

  • Maine Medical Partners Scarborough Family Medicine Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497068969. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
22 Bramhall St
Portland, ME 41023134
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 51

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • Maine Medical Partners
    • Surgery Physician
    • Scarborough, ME
    • NPI 1346687167

    O20040701000166

    Same enrollment
  • Mainehealth

    dba MMP Orthopedics ( Div of Orthopedic Trauma & Fracture Care)

    • Orthopaedic Trauma Physician
    • Portland, ME
    • NPI 1003113127

    O20071116000569

    Same enrollment
  • Mainehealth
    • Internal Medicine Physician
    • Windham, ME
    • NPI 1023321593

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth

    dba Maine Hemophilia and Thrombosis Center

    • General Acute Care Hospital
    • Scarborough, ME
    • NPI 1053647024

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth
    • Maternal & Fetal Medicine Physician
    • Portland, ME
    • NPI 1063726891

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth

    dba Maine Medical Center Infectious Disease

    • Infectious Disease Physician
    • Portland, ME
    • NPI 1073701157

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth

    dba Geriatric Consults

    • Geriatric Medicine (Internal Medicine) Physician
    • Portland, ME
    • NPI 1164610242

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth

    dba SMHC Physician Services

    • Multi-Specialty Clinic/Center
    • Biddeford, ME
    • NPI 1215417019

    O20040701000166

    Same enrollment
  • Mainehealth

    dba MaineHealth Virtual Care Virtual Quick Care

    • Urgent Care Clinic/Center
    • Portland, ME
    • NPI 1265251540

    O20040701000166

    Same enrollment
  • Mainehealth

    dba MMC Pediatric Intensive Care Unit

    • Pediatric Critical Care Medicine Physician
    • Portland, ME
    • NPI 1265536817

    O20040701000166, O20071116000569

    Same enrollment
  • Mainehealth

    dba MaineHealth Behavioral Health

    • Community/Behavioral Health Agency
    • Portland, ME
    • NPI 1265912067

    O20040701000166

    Same enrollment
  • Mainehealth

    dba MaineHealth Waldo Hospital

    • Critical Access Hospital
    • Belfast, ME
    • NPI 1265912075

    O20040701000166

    Same enrollment
View all 51

Care Compare: Hospital

Medicare Care Compare
Listed as
Mainehealth Maine Medical CenterCCN 200009 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Maine Medical Assoc

Locations

329 Maine St
#E101
Brunswick, ME 04011
Phone (207) 373-2266

Ownership & related parties

All disclosed owners & managing parties 33

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nancy a Hasenfus Individual Corporate Director Jan 1, 2019
Brett Loffredo Individual Corporate Director Jan 1, 2019
Brian H Noyes Individual Corporate DirectorBoard Member Oct 1, 2016
Dawn M Tutt Individual W-2 Managing EmployeeManager RCM System Support Dec 30, 2013
Marie J McCarthy Individual Corporate DirectorBoard Member Oct 1, 2016
Matthew Chin Individual Corporate Director Apr 1, 2025
Katherine B Coster Individual Corporate DirectorBoard Member Oct 1, 2016
Beth Kelsch Individual Corporate OfficerSecretary Apr 1, 2025
Robert Hunter Individual Corporate OfficerSenior Vice President Dec 1, 2025
Ann W Bresnahan Individual Corporate DirectorDirector Oct 1, 2023
Christopher Cimino Individual Corporate Director Oct 1, 2025
Andrew T Mueller Individual Corporate OfficerCeo, Mainehealth Jul 1, 2021
Lisa T Beaule Individual Corporate Director Jan 1, 2019
Charles Richard Bayman Individual Corporate OfficerChief Financial Officer Dec 1, 2025
Corporate DirectorChief Financial Officer Dec 1, 2025
Christopher C Coon Individual Corporate OfficerVP Finance Jan 1, 2016
Kelly a Elkins Individual Corporate Officer Jan 1, 2022
Jennifer Kent Individual Corporate Director Oct 1, 2025
Peter W Wood Individual Corporate Director Jan 1, 2022
Thomas J Ryan Individual Corporate Director Jan 1, 2019
David J Kumaki Individual Corporate Director Jan 1, 2019
Quincy Hentzel Individual Corporate Director Apr 1, 2025
Morris L Fisher Individual Corporate DirectorBoard Member Jun 1, 2013
Leslie Clinton Boothby Individual Corporate Director Jan 1, 2019
Kathleen Herlihy Individual Corporate Director Jan 1, 2019
Mainehealth Services Organization, Portland, ME Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2019 100%
Operational/Managerial Control Jan 1, 2019 100%
Linda M. Terry Individual Corporate Director Jan 1, 2022
Peter C Manning Individual Corporate Director Jan 1, 2019
Alissa Chasse Individual W-2 Managing EmployeeRCM Systems Coordinator II Jan 1, 2025
Daniel L Loiselle Individual Corporate Director Jan 1, 2019
Kelly Champney Individual Corporate OfficerSenior Vice President Jun 1, 2026
Matthew P Orlando Individual Corporate DirectorDirector Oct 1, 2024
Stuart H Watson Individual Corporate Director Jan 1, 2022
Amanda Rand Individual Corporate Director Jan 1, 2023

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 75

Affiliated clinicians 2,518

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 2,518

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1497068969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PROFESSIONAL DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-883-3491",
            "fax_number": "207-883-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAINE MEDICAL CENTER",
        "enumeration_date": "2010-07-26",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "INZANA",
        "authorized_official_first_name": "LUGENE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "SVP FINANCE/CFO",
        "authorized_official_telephone_number": "207-662-3538"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ME",
            "license": "37563",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Maine Medical Partners Scarborough Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Maine Medical Partners Scarborough Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.