NPIMap

Individual provider Active NPI

Nicole Rendall

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1588399752
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP221344 Issued in ME
Practice address
66 Bramhall St Ste G1
Portland, ME 04102-3344
Phone
(207) 662-3157
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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 CNP221344 ME Primary

Addresses

Primary practice location

66 Bramhall St Ste G1
Portland, ME 04102-3344

Mailing address

35 Medical Center Pkwy
Augusta, ME 04330-8160

Other practice location 1

222 N Pacific Coast Hwy Ste 2175
El Segundo, CA 90245-5639
Phone (877) 878-3289

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126003071 ME Practitioner - Nurse Practitioner 3577934694 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Feb 27, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Family CurrentSince Feb 27, 2023 Accepting new patients
Mainehealth CurrentSince Feb 27, 2023 Accepting new patients
Robert Marriott Medical Corp CurrentSince Jan 3, 2023 Accepting new patients
Maine Medical Partners CurrentSince Feb 27, 2023 Accepting new patients
Maine Medical Partners Current Accepting new patients
Scarborough Operations, LLC Past Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

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

66 Bramhall St
Ste G1
Portland, ME 04102
Phone (207) 662-2847

67 Pine Point Rd
Scarborough, ME 04074
Phone (207) 883-2468

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

370 Portland St
Yarmouth, ME 04096
Phone (207) 846-9021

Interoperability endpoints

  • Direct secure messaging: nrendall565367@direct.mmc.mainehealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1588399752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST STE G1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023344",
            "telephone_number": "207-662-3157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 N Pacific Coast Hwy Ste 2175",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902455639",
            "country_code": "US",
            "telephone_number": "877-878-3289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENDALL",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP221344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.