Individual provider Active NPI

Jennie Yamartino

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1588071385
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW78813 Issued in CA
Practice address
180 Park Ave Ste 1
Portland, ME 04102-2927
Phone
(207) 874-2141
Fax
(207) 874-2164
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW78813 CA Primary

Addresses

Primary practice location

180 Park Ave Ste 1
Portland, ME 04102-2927

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190115003812 ME Practitioner - Clinical Social Worker 4880930650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Community Health CenterGroup PAC ID 5395998017, 37 clinicians

Practice addresses (Care Compare)

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW78813CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Community Health Center CurrentSince Nov 17, 2018 Accepting new patients
Portland Community Health Center CurrentSince Nov 17, 2018 Accepting new patients
Portland Community Health Center Current Accepting new patients
Portland Community Health Center Past Accepting new patients

Locations

180 Park Ave
Portland, ME 04102
Phone (207) 772-3703

180 Park Ave
Ste 1
Portland, ME 04102
Phone (207) 828-2101

Interoperability endpoints

  • Direct secure messaging: jennie.yamartino.p1@direct.portlandchc.nextgenshare.com

Organizations & group practices 4

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1588071385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022927",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMARTINO",
        "first_name": "JENNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW78813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.