NPIMap

Individual provider Active NPI

Elizabeth Kasny Sundborg, FNP

  • Family Nurse Practitioner
  • Westbrook, ME
National Provider Identifier
1750835377
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP161061 Issued in ME
Practice address
1 Harnois Ave Ste 2a
Westbrook, ME 04092-4395
Phone
(207) 661-3400
Fax
(207) 661-3401
NPI assigned
Aug 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN55933 ME
Pulmonary Disease Physician 207RP1001X CNP161061 ME
Family Nurse Practitioner 363LF0000X CNP161061 ME Primary

Addresses

Primary practice location

1 Harnois Ave Ste 2a
Westbrook, ME 04092-4395

Mailing address

190 Riverside St Unit 6B
Portland, ME 04103-1073
Phone (207) 661-2000

Other names 1

  • Elizabeth A. Kasny Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405001582 ME Practitioner - Nurse Practitioner 0446548424 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
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)

1 Harnois Ave
Westbrook, ME 04092-4395

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

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN55933MEMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Mar 6, 2019 Accepting new patients
Maine Medical Partners Family CurrentSince Mar 6, 2019 Accepting new patients
Mainehealth CurrentSince Mar 6, 2019 Accepting new patients
Maine Medical Partners CurrentSince Mar 6, 2019 Accepting new patients
Maine Medical Partners CurrentSince Mar 6, 2019 Accepting new patients
Maine Medical Partners CurrentSince Mar 6, 2019 Accepting new patients
Maine Medical Partners CurrentSince Apr 14, 2020 Accepting new patients
Maine Medical Partners CurrentSince Mar 6, 2019 Accepting new patients
Chest Medicine Associates, PA Pulmonary Disease CurrentSince Feb 25, 2017 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Mar 6, 2019 Accepting new patients

Locations

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

272 Congress St
Portland, ME 04101
Phone (207) 874-2466

190 Riverside St
Unit 6B
Portland, ME 04103

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

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

100 Foden Rd
#103
South Portland, ME 04106
Phone (207) 828-1122

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

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

1 Harnois Ave
Ste 2A
Westbrook, ME 04092
Phone (207) 661-3400

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

Interoperability endpoints

  • Direct secure messaging: esundborg245767@direct.mmc.mainehealth.org

Organizations & group practices 12

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1750835377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST UNIT 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073",
            "telephone_number": "207-661-2000",
            "fax_number": "207-661-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARNOIS AVE STE 2A",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924395",
            "telephone_number": "207-661-3400",
            "fax_number": "207-661-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDBORG",
        "first_name": "ELIZABETH",
        "middle_name": "KASNY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN55933",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ME",
            "license": "CNP161061",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP161061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KASNY",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.