NPIMap

Organization Active NPI

Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Auburn, ME
National Provider Identifier
1609567106
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CONVENIENTMD - FFS UC LLC
Practice address
600 Center St
Auburn, ME 04210-6311
Phone
(207) 955-5565
NPI assigned
May 16, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Jarod Boissonneault
Title
VP, Revenue Cycle Management
Phone
(603) 410-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

600 Center St
Auburn, ME 04210-6311

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230803000124 ME Part B Supplier - Clinic/Group Practice 5193186492 Receives reassigned benefits from 167 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, ME; Westbrook, ME; Sanford, ME; Saco, ME; Farmington, ME; Ellsworth, ME; Brunswick, ME; Belfast, ME…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1609567106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CENTER ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106311",
            "telephone_number": "207-955-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENTMD - FFS UC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "BOISSONNEAULT",
        "authorized_official_first_name": "JAROD",
        "authorized_official_title_or_position": "VP,  REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "603-410-6700"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.