Active NPI
Michael Stephen Bohanske, M.D.
- Emergency Medicine Physician
- Portland, ME
National Provider Identifier
1508156985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD20922
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-2381
- Fax
- (207) 662-6226
- NPI assigned
- Apr 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 35 123526 | OH | |
| Emergency Medicine Physician | 207P00000X | MD20922 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
190 Riverside St
Suite 6B
Portland, ME 04103-1073
Phone (207) 661-2000
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160721000077 | ME | Practitioner - Emergency Medicine | 4082853551 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Warren Alpert Medical School of Brown University, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mainehealth
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280
Hospital & facility affiliations
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35 123526 | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Emergency Medicine | Current | Accepting new patients |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- mbohanske141829@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.
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493251200000",
"number": "1508156985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 RIVERSIDE ST",
"address_2": "SUITE 6B",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041031073",
"telephone_number": "207-661-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-662-2381",
"fax_number": "207-662-6226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHANSKE",
"first_name": "MICHAEL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-19",
"last_updated": "2017-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35 123526",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ME",
"license": "MD20922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.