NPIMap

Individual provider Active NPI

David L Ciraulo, DO

  • Surgery Physician
  • Portland, ME
National Provider Identifier
1780779132
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1841 Issued in ME
Practice address
887 Congress St.
Suite 210
Portland, ME 04102
Phone
(207) 774-2344
Fax
(207) 774-0459
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1841 ME Primary

Addresses

Primary practice location

887 Congress St.
Suite 210
Portland, ME 04102

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
411880099MedicaidME
30223005MedicaidNH

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
I20040809000957 ME Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 6305818519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1841MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Aug 1, 2004 Accepting new patients
Mainehealth CurrentSince Jan 1, 2009 Accepting new patients
Mainehealth CurrentSince Jan 1, 2009 Accepting new patients
Maine Medical Partners Surgery CurrentSince Aug 1, 2004 Accepting new patients
Maine Medical Partners Surgery Current Accepting new patients
Mainehealth Current Accepting new patients
Ut Physicians Inc Past Accepting new patients
University Surgical Associates PC Surgery Past Accepting new patients
Northern Maine Medical Center Past Accepting new patients
University Surgical Associates, PLLC Surgery Past Accepting new patients

Locations

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

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

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

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71772

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1780779132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST",
            "address_2": "SUITE 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073",
            "telephone_number": "207-661-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST.",
            "address_2": "SUITE 210",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-774-2344",
            "fax_number": "207-774-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRAULO",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "1841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411880099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30223005",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.