NPIMap

Organization Active NPI

Peds Coverage PC

  • Pediatrics Physician
  • Portland, ME
National Provider Identifier
1548730567
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDS COVERAGE PC
Practice address
1577 Congress St
Portland, ME 04102-2169
Phone
(207) 662-1442
NPI assigned
Dec 3, 2018
Last updated
Dec 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
Steven Blumenthal, MDNPI 1275565384
Title
Owner
Phone
(207) 553-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1577 Congress St
Portland, ME 04102-2169

Mailing address

PO Box 1778
Lewiston, ME 04241-1778
Phone (207) 375-3024

Other identifiers 1

IdentifierTypeStateIssuer
1275565384MedicaidME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1548730567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1778",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411778",
            "telephone_number": "207-375-3024",
            "fax_number": "207-375-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022169",
            "telephone_number": "207-662-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS COVERAGE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "BLUMENTHAL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-553-6300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275565384",
            "state": "ME"
        }
    ],
    "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 Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.