Individual provider Active NPI

Erin Morneault

  • Pediatrics Physician
  • South Portland, ME
National Provider Identifier
1588877336
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2040 Issued in ME
Practice address
75 John Roberts Rd BLDG B
South Portland, ME 04106-6964
Phone
(207) 775-4151
Fax
(207) 775-6950
NPI assigned
May 8, 2007
Last updated
Jan 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 2040 ME Primary

Addresses

Primary practice location

75 John Roberts Rd BLDG B
South Portland, ME 04106-6964

Mailing address

301 US Route 1
Scarborough, ME 04074-7609
Phone (207) 396-8600

Other identifiers 1

IdentifierTypeStateIssuer
432879699MedicaidME

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809000931 ME Practitioner - Pediatric Medicine 0042388662 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2040MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 28, 2021 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Jun 28, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jun 28, 2021 Accepting new patients
Mainehealth CurrentSince Jun 28, 2021 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Pediatrics Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

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

75 John Roberts Rd
Bldg B
South Portland, ME 04106
Phone (207) 662-5522

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

Interoperability endpoints

  • Direct secure messaging: emorneault1299@direct.mmc.mainehealth.org

Organizations & group practices 7

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1588877336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JOHN ROBERTS RD BLDG B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066964",
            "telephone_number": "207-775-4151",
            "fax_number": "207-775-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORNEAULT",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "2040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432879699",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.