NPIMap

Organization Active NPI

Intermed, PA

  • Family Medicine Physician
  • South Portland, ME
National Provider Identifier
1609755701
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTERMED, PA
Practice address
100 Foden Rd, East
Suite 203
South Portland, ME 04106-1715
Phone
(207) 874-1489
NPI assigned
Sep 2, 2025
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Roger A. Poitras
Title
Chief Executive Officer
Phone
(207) 347-2853

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

100 Foden Rd, East
Suite 203
South Portland, ME 04106-1715

Mailing address

100 Gannett Dr Ste C
South Portland, ME 04106-5900
Phone (207) 347-2947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930090971 ME DME Supplier - Physician - Physical and Rehabilitation 5092605261 1 other NPI on this enrollment
Practice locations: South Portland, ME

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Daniel Pierce MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1609755701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-347-2947",
            "fax_number": "207-874-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FODEN RD, EAST",
            "address_2": "SUITE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061715",
            "telephone_number": "207-874-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMED, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-02",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "POITRAS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-347-2853"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.