Individual provider Active NPI

Oliver T Fremont, M.D.

  • Pediatric Nephrology Physician
  • Portland, ME
National Provider Identifier
1730127036
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
MD17844 Issued in ME
Practice address
887 Congress St
Suite 320
Portland, ME 04102-3100
Phone
(207) 662-5522
Fax
(207) 662-5527
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 224066 MA
Pediatric Nephrology Physician 2080P0210X MD17844 ME Primary

Addresses

Primary practice location

887 Congress St
Suite 320
Portland, ME 04102-3100

Mailing address

301 US Route 1
Building C
Scarborough, ME 04074-7609
Phone (207) 396-8600

Other identifiers 2

IdentifierTypeStateIssuer
30207900MedicaidNH
433012199MedicaidME

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
I20081006000681 ME Practitioner - Pediatric MedicinePractitioner - Other (Physician) 0749358596 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Missouri, Columbia School of Medicine, 2002
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

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
224066MAMDPediatrics Physician
MD17844MEMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 25, 2023 Accepting new patients
Maine Medical Partners Pediatrics Current Accepting new patients
Maine Medical Partners CurrentSince Jul 21, 2008 Accepting new patients
Maine Medical Partners CurrentSince Jun 1, 2013 Accepting new patients
Maine Medical Partners Pediatric Nephrology CurrentSince Apr 1, 2014 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Jul 25, 2023 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jul 21, 2008 Accepting new patients
Mainehealth Pediatrics Past Accepting new patients

Locations

887 Congress St
Ste 100
Portland, ME 04102
Phone (207) 662-5522

887 Congress St
Ste 300
Portland, ME 04102
Phone (207) 662-5555

887 Congress St
Ste 320
Portland, ME 04102
Phone (207) 662-5522

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

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

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

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

55 Spring St
Scarborough, ME 04074
Phone (207) 396-7337

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

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

Interoperability endpoints

  • Direct secure messaging: ofremont1307@direct.mmc.mainehealth.org

Organizations & group practices 10

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1730127036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "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": "887 CONGRESS ST",
            "address_2": "SUITE 320",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-662-5522",
            "fax_number": "207-662-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREMONT",
        "first_name": "OLIVER",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "224066",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "ME",
            "license": "MD17844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30207900",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433012199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.