Individual provider Active NPI

Kyle Adam Dill, FNP

  • Family Nurse Practitioner
  • Brunswick, ME
National Provider Identifier
1497529523
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP231358 Issued in ME
Practice address
81 Medical Center Dr
Brunswick, ME 04011-2764
Phone
(207) 721-8333
Fax
(297) 618-5670
NPI assigned
Nov 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP231358 ME Primary

Addresses

Primary practice location

81 Medical Center Dr
Brunswick, ME 04011-2764

Mailing address

30 Hamblet Ave
Portland, ME 04103-1714
Phone (207) 809-9119

Other identifiers 1

IdentifierTypeStateIssuer
CNP231358OtherMEMAINE STATE NURSE PRACTITIONER LICENSE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111003158 ME Practitioner - Nurse Practitioner 1759732985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 26, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Dec 26, 2023 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: kdill566561@direct.mmc.mainehealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1497529523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAMBLET AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031714",
            "telephone_number": "207-809-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112764",
            "telephone_number": "207-721-8333",
            "fax_number": "297-618-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILL",
        "first_name": "KYLE",
        "middle_name": "ADAM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP231358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE STATE NURSE PRACTITIONER LICENSE",
            "identifier": "CNP231358",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.