NPIMap

Individual provider Active NPI

Christine L Petersen, MD

  • Diagnostic Radiology Physician
  • Portland, ME
National Provider Identifier
1578554044
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
220273 Issued in MA
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-4735
NPI assigned
Nov 2, 2005
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 220273 MA Primary
Diagnostic Radiology Physician 2085R0202X MD25614 ME

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 2

IdentifierTypeStateIssuer
1578554044MedicaidME
2061350OtherMASSMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040728001447 MA Practitioner - Diagnostic Radiology 5395715130 Reassigns benefits to 2 organizations
I20220527001575 ME Practitioner - Diagnostic Radiology 5395715130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25614MEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial MRI & Imaging Center LLC CurrentSince Mar 6, 2023 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Mar 6, 2023 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC Diagnostic Radiology CurrentSince Mar 6, 2023 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Mar 6, 2023 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Feb 28, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Feb 28, 2023 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology PastSince Jun 26, 2022 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients
Mainehealth Past Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology Past Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology Past Accepting new patients

Locations

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

10 Little Brook Rd
West Wareham, MA 02576

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1578554044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "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": "207-662-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "220273",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD25614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578554044",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSMEDICAID",
            "identifier": "2061350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.