Mainegeneral Health Rehabilitation & Long Term Care

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

AT965 Issued in ME

Legal business name

MAINEGENERAL HEALTH REHABILITATION & LONG TERM CARE

Practice address

40 Glenridge Drive
Augusta, ME 04330-6606

Phone

(207) 626-2600

Fax

(207) 621-0277

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Pizzo, MBA

Title

Director of Finance

Phone

(207) 861-3451

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Skilled nursing facility certification: CCN 205139A

Legal name

MAINEGENERAL HEALTH REHABILITATION & LONG TERM CARE

Organization structure

CorporationNon-profit

Incorporated

Dec 4, 1986 in ME

Enrollment address

40 Glenridge Dr
Augusta, ME 04330-6606

Nursing home name

MAINEGENERAL REHAB & LONG TERM CARE - GLENRIDGE

Other NPIs with the same Medicare PAC ID 1

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

• Mainegeneral Health Rehabilitation & Long Term Care

  • Skilled Nursing Facility
  • Augusta, ME
  • NPI 1659362481

  4183904584

  Same PAC ID

Tax ID family

Alzheimer'S Care Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

• Maine General Health Rehabilitation & Long Term Care

  • Adult Day Care Clinic/Center
  • Gardiner, ME
  • NPI 1275777880
  NPD tax ID
• Maine General Health Rehabilitation & Long Term Care

  • Alzheimer Center (Dementia Center)
  • Gardiner, ME
  • NPI 1366592461
  NPD tax ID
• Mainegeneral Health Rehabilitation & Long Term Care

  • Skilled Nursing Facility
  • Augusta, ME
  • NPI 1659362481
  NPD tax ID
• Mainegeneral Health Rehabilitation and Long Term Care

  • Assisted Living Facility
  • Augusta, ME
  • NPI 1083754295
  NPD tax ID
• Mainegeneral Rehabilitation and Long Term Care

  • Assisted Living Facility
  • Augusta, ME
  • NPI 1912044363
  NPD tax ID
• Mainegeneral Rehabilitation and Nursing Care

  • Respite Care
  • Augusta, ME
  • NPI 1467789008
  NPD tax ID

Locations

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• John W Diefenderfer, D.O.

  • Family Medicine Physician
  • Waterville, ME
  • NPI 1407236185

  Corporate Director

  CMS ownership
• Deirdre Heersink, DO

  • Family Medicine Physician
  • Topsham, ME
  • NPI 1417157298

  Adp of the SNF, Corporate Director, Operational/Managerial Control

  CMS ownership
• Amy C Rico, MD

  • Hospitalist Physician
  • Augusta, ME
  • NPI 1841238730

  Corporate Director

  CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Mainegeneral Health Rehabilitation & Long Term Care

  • Skilled Nursing Facility
  • Augusta, ME
  • NPI 1659362481

  Mainegeneral Health

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Paul Dohner, DO

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Augusta, ME
  • NPI 1154315620
  NPD (past)
• Joann Wang, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Augusta, ME
  • NPI 1134369358
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1679564017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GLENRIDGE DRIVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306606",
            "telephone_number": "207-626-2600",
            "fax_number": "207-621-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GLENRIDGE DRIVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306606",
            "telephone_number": "207-626-2600",
            "fax_number": "207-621-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEGENERAL HEALTH REHABILITATION & LONG TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "PIZZO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "207-861-3451",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "AT965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165230000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mainegeneral Health Associates
• Mainegeneral Health Associates
• Mainegeneral Health Associates
• Mainegeneral Health Associates
• Mainegeneral Health Rehabilitation & Long Term Care
• Mainegeneral Health Rehabilitation and Long Term Care
• Mainegeneral Medical Center
• Mainegeneral Medical Center
• Mainegeneral Medical Center
• Mainegeneral Medical Center

• Skilled Nursing Facility in Augusta, ME
• Providers in Augusta, ME by specialty
• Skilled Nursing Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.