NPIMap

Individual provider Active NPI

Emmanuel Nicholas Soultanakis, MD

  • Gynecologic Oncology Physician
  • Scarborough, ME
National Provider Identifier
1659489284
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MD19505 Issued in ME
Practice address
102 Campus Dr
Scarborough, ME 04074-9692
Phone
(207) 883-0069
Fax
(207) 883-0999
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 2025005986 MO
Gynecologic Oncology Physician 207VX0201X 042-0010087 VT
Gynecologic Oncology Physician 207VX0201X MD19505 ME Primary

Addresses

Primary practice location

102 Campus Dr
Scarborough, ME 04074-9692

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130219000000 ME Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 0345131678 Reassigns benefits to 1 organization
I20250319003101 MO Practitioner - Gynecological Oncology 0345131678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
University of Vermont College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

Hospital & facility affiliations

  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Saint Lukes North Hospital Hospital, Kansas City, MO, CCN 260062
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2013 Accepting new patients
Mainehealth Current Accepting new patients
Saint Luke'S Physician Group Inc CurrentSince Mar 10, 2025 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2013 Accepting new patients
Maine Medical Partners Obstetrics & Gynecology CurrentSince Jan 1, 2013 Accepting new patients
Mainehealth CurrentSince Jan 1, 2013 Accepting new patients
University of Vermont Medical Center Inc Obstetrics & Gynecology Past Accepting new patients
University of Vermont Medical Group New York PLLC Obstetrics & Gynecology Past Accepting new patients

Locations

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

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

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

100 Campus Dr
Unit 125
Scarborough, ME 04074
Phone (207) 883-0069

102 Campus Dr
Scarborough, ME 04074
Phone (207) 883-0069

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: esoultanakis670016@direct.saint-lukes.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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1659489284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "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": "102 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749692",
            "telephone_number": "207-883-0069",
            "fax_number": "207-883-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULTANAKIS",
        "first_name": "EMMANUEL",
        "middle_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MO",
            "license": "2025005986",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "VT",
            "license": "042-0010087",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "ME",
            "license": "MD19505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.