Raghu Nandan Kanumalla, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO3417 Issued in ME

Practice address

895 Union St Ste 12
Bangor, ME 04401-3054

Phone

(207) 973-7979

Fax

(207) 947-9579

NPI assigned

Jun 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Bangor, ME, CCN 207045
• Northern Light Home Care & Hospice Home health agency, So Portland, ME, CCN 207020
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050

Merit-based Incentive Payment System (MIPS)

Final score

84.1 of 100Reported as group

Quality

64.8

Promoting interoperability

96

Improvement activities

40

Cost

68.87

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD

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

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Bangor, ME
  • NPI 1982638771
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Maine Coast Regional Health Facilities

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• MRH Corp.

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation
• Vna Home Health & Hospice

  • Home Health Agency
  • South Portland, ME
  • NPI 1245236306
  Care Compare affiliation

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1497313696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 UNION ST STE 12",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013054",
            "telephone_number": "207-973-7979",
            "fax_number": "207-947-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUMALLA",
        "first_name": "RAGHU",
        "middle_name": "NANDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO3417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kaiser, M.D.
• Hannah Jasmine Kaleebi, MD
• Mahmoud Hamdy Ibrahim Kamel, MD
• Arthur Gilbert Kane, M.D.
• Rima Kanhoush, M.D.
• Kimberly Karam
• Ansu Karki, MBBS
• Aaron Seth Karmes, D.O.
• Laurie A Karnes, MSN
• Katelyn Karr

• Family Medicine Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.
• 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.