John Luke Pontolillo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD24522 Issued in ME

Practice address

489 State St
Bangor, ME 04401-6616

Phone

(207) 793-7000

NPI assigned

Apr 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Diagnostic Radiology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Healthcare Partners PAGroup PAC ID 7618871245, 305 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
• Northern Light Blue Hill Memorial Hospital Hospital, Blue Hill, ME, CCN 201300

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Spectrum Healthcare Partners, PA

  • Diagnostic Radiology Physician
  • Bangor, ME
  • NPI 1710993159
  Medicare reassignment Care Compare group NPD
• Insight-Premier Health LLC

  • Diagnostic Radiology Physician
  • Bangor, ME
  • NPI 1922655562
  NPD
• Spectrum Healthcare Partners, P.a.

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, ME
  • NPI 1386757607
  NPD

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

• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• Maine Coast Regional Health Facilities

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• MRH Corp.

  • Critical Access Hospital
  • Dover Foxcroft, ME
  • NPI 1558319103
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation
• The Blue Hill Memorial Hospital

  • Critical Access Hospital
  • Blue Hill, ME
  • NPI 1023057809
  Care Compare affiliation

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1790170926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-793-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_2": "HCMC Dept. of Radiology",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-347-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONTOLILLO",
        "first_name": "JOHN",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2021-05-07",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD24522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790170926",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Robert Poglese, PA
• Meghan Paige Pojasek
• Jessica Marie Poland, OT
• Jessica Marie Pollard, PHD
• Sylvia Pond, LCSW
• Christina Marie Pool, MS, CGC
• Henrietta S Poons, LCPC
• Matthew Popovich, PA-C
• Frederick Port, DMD
• Kaileigh M Porter, RD CDE

• Diagnostic Radiology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Diagnostic Radiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.