Individual provider Active NPI

John J Gullo, MD

  • Medical Oncology Physician
  • Brunswick, ME
National Provider Identifier
1700865243
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD21675 Issued in ME
Practice address
329 Maine St Ste E101
Brunswick, ME 04011-3310
Phone
(207) 373-2266
Fax
(207) 910-4413
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD21675 ME
Hematology (Internal Medicine) Physician 207RH0000X MD21675 ME
Hematology & Oncology Physician 207RH0003X 137981-1 NY
Medical Oncology Physician 207RX0202X MD21675 ME Primary

Addresses

Primary practice location

329 Maine St Ste E101
Brunswick, ME 04011-3310

Mailing address

329 Maine St Ste E101
Brunswick, ME 04011-3310
Phone (207) 373-2266

Other practice location 1

5008 Brittonfield Pkwy
Suite 700
East Syracuse, NY 13057-9248
Phone (315) 472-7504

Other practice location 2

116 Northport Ave Ste 112
Belfast, ME 04915-6096
Phone (207) 505-4163

Other practice location 3

159 Main St
Norway, ME 04268-5638
Phone (207) 743-2945

Other practice location 4

265 Western Ave Ste 2
South Portland, ME 04106-2458
Phone (207) 661-0200

Other identifiers 1

IdentifierTypeStateIssuer
00602671MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171120002555 ME Practitioner - Medical OncologyPractitioner - Internal Medicine 0345141479 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
State University of Ny Upstate Medical University, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

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

329 Maine St
Brunswick, ME 04011-3310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
137981-1NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 1, 2018 Accepting new patients
Mainehealth CurrentSince Jan 1, 2026 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Feb 17, 2018 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Feb 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Hematology & Oncology CurrentSince Mar 9, 2021 Accepting new patients
Mainehealth CurrentSince Feb 24, 2018 Accepting new patients
Mainehealth CurrentSince Dec 1, 2018 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Feb 17, 2018 Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

116 Northport Ave
Ste 220
Belfast, ME 04915
Phone (207) 505-4015

116 Northport Ave
Ste 112
Belfast, ME 04915
Phone (207) 505-4163

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

329 Maine St
#E101
Brunswick, ME 04011
Phone (207) 373-2266

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4420

159 Main St
Norway, ME 04268
Phone (207) 743-2945

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

265 Western Ave
Ste 2
South Portland, ME 04106
Phone (207) 661-0200

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

Interoperability endpoints

  • Direct secure messaging: jgullo209428@direct.mmc.mainehealth.org

Organizations & group practices 11

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1700865243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 MAINE ST STE E101",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113310",
            "telephone_number": "207-373-2266",
            "fax_number": "207-910-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 MAINE ST STE E101",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113310",
            "telephone_number": "207-373-2266",
            "fax_number": "207-910-4413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5008 Brittonfield Pkwy",
            "address_2": "Suite 700",
            "address_purpose": "LOCATION",
            "city": "East Syracuse",
            "state": "NY",
            "postal_code": "130579248",
            "country_code": "US",
            "telephone_number": "315-472-7504",
            "fax_number": "315-479-8639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Northport Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156096",
            "country_code": "US",
            "telephone_number": "207-505-4163",
            "fax_number": "207-613-2570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "159 Main St",
            "address_purpose": "LOCATION",
            "city": "Norway",
            "state": "ME",
            "postal_code": "042685638",
            "country_code": "US",
            "telephone_number": "207-743-2945",
            "fax_number": "207-743-2751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Western Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041062458",
            "country_code": "US",
            "telephone_number": "207-661-0200",
            "fax_number": "207-661-0299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLO",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD21675",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "ME",
            "license": "MD21675",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "137981-1",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "ME",
            "license": "MD21675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00602671",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.