Active NPI
Collin McCloskey Leibold, MD
- Family Medicine Physician
- Scarborough, ME
National Provider Identifier
1629728555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD30314
- Practice address
- 49 Spring St Ste 101
Scarborough, ME 04074-8926 - Phone
- (207) 883-7926
- Fax
- (207) 618-5021
- NPI assigned
- Mar 24, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD30314 | ME | |
| Family Medicine Physician | 207Q00000X | MD30314 | ME | Primary |
Addresses
Primary practice location
49 Spring St Ste 101
Scarborough, ME 04074-8926
Mailing address
49 Spring St Ste 101
Scarborough, ME 04074-8926
Phone (207) 883-7926
Other practice location 1
272 Congress St
Portland, ME 04101-3637
Phone (207) 874-2466
Other practice location 2
5 Bucknam Rd Ste 2C
Falmouth, ME 04105-1209
Phone (207) 781-1500
Other practice location 3
1215 Lee St # 800499
Charlottesville, VA 22908-0816
Phone (434) 924-5348
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260615000881 | ME | Practitioner - Family Practice | 4789062308 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Riverfront PLZ
Westbrook, ME 04092-2986
1 Riverfront PLZ
Westbrook, ME 04092-9700
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD30314 | ME | MD | Family Medicine Physician |
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1629728555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 SPRING ST STE 101",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040748926",
"telephone_number": "207-883-7926",
"fax_number": "207-618-5021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 SPRING ST STE 101",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040748926",
"telephone_number": "207-883-7926",
"fax_number": "207-618-5021"
}
],
"practiceLocations": [
{
"address_1": "272 Congress St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041013637",
"country_code": "US",
"telephone_number": "207-874-2466",
"fax_number": "207-774-4625",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Bucknam Rd Ste 2C",
"address_purpose": "LOCATION",
"city": "Falmouth",
"state": "ME",
"postal_code": "041051209",
"country_code": "US",
"telephone_number": "207-781-1500",
"fax_number": "207-781-1507",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1215 Lee St # 800499",
"address_purpose": "LOCATION",
"city": "Charlottesville",
"state": "VA",
"postal_code": "229080816",
"country_code": "US",
"telephone_number": "434-924-5348",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEIBOLD",
"first_name": "COLLIN",
"middle_name": "MCCLOSKEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-24",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "ME",
"license": "MD30314",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "MD30314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.