Individual provider Active NPI

Phyllis Adrienne Wolf, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, ME
National Provider Identifier
1689819492
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA203073 Issued in ME
Practice address
84 Marginal Way Ste 1000
Portland, ME 04101-2477
Phone
(207) 347-2898
Fax
(207) 553-1415
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA203073 ME Primary

Addresses

Primary practice location

84 Marginal Way Ste 1000
Portland, ME 04101-2477

Mailing address

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

Other practice location 1

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Other practice location 2

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210907002617 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294889556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNA203073MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 6, 2021 Accepting new patients
Mainehealth Current Accepting new patients
Intermed, PA CurrentSince Dec 17, 2023 Accepting new patients
Intermed, PA CurrentSince Dec 17, 2023 Accepting new patients
Mainehealth CurrentSince Sep 6, 2021 Accepting new patients

Locations

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

84 Marginal Way
Ste 1000
Portland, ME 04101
Phone (207) 347-2898

84 Campus Dr
Scarborough, ME 04074
Phone (207) 396-7000

100 Gannett Dr
Ste C
South Portland, ME 04106
Phone (207) 523-3649

100 Foden Rd
South Portland, ME 04106
Phone (207) 828-1122

100 Foden Rd
Ste W-100
South Portland, ME 04106
Phone (207) 523-3900

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1689819492",
    "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": "84 MARGINAL WAY STE 1000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012477",
            "telephone_number": "207-347-2898",
            "fax_number": "207-553-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Scarborough",
            "state": "ME",
            "postal_code": "040747133",
            "country_code": "US",
            "telephone_number": "207-396-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-2526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "PHYLLIS",
        "middle_name": "ADRIENNE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA203073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.