NPIMap

Organization Active NPI

Mainehealth

Doing business as Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
National Provider Identifier
1790265502
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
37984 Issued in ME
Legal business name
MAINEHEALTH
Doing business as
Mainehealth Behavioral Health
Practice address
123 Andover Rd
Westbrook, ME 04092-3848
Phone
(207) 761-2200
NPI assigned
Aug 21, 2018
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Lugene Anthony Inzana
Title
SVP Finance, Cfo
Phone
(207) 662-2654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 37984 ME Primary

Addresses

Primary practice location

123 Andover Rd
Westbrook, ME 04092-3848

Mailing address

78 Atlantic PL
South Portland, ME 04106-2316

Other identifiers 1

IdentifierTypeStateIssuer
132600000MedicaidME

Other names 2

  • MAINEHEALTH BEHAVIORAL HEALTH Doing business as
  • Maine Medical Center Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701000166 ME Part B Supplier - Clinic/Group Practice 7517860588 Receives reassigned benefits from 3,561 practitioners
38 other NPIs on this enrollment

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mid Coast Senior Health CenterBrunswick, ME, CCN 205163 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jan 1, 2021
Oct 16, 2025
Coves EdgeDamariscotta, ME, CCN 205067 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jan 1, 2019
Jan 1, 2019
Jan 1, 2019

Practitioners & affiliated clinicians

Practitioners 3,827

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 3,827

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1790265502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923848",
            "telephone_number": "207-761-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "INZANA",
        "authorized_official_first_name": "LUGENE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "SVP FINANCE, CFO",
        "authorized_official_telephone_number": "207-662-2654"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "ME",
            "license": "37984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132600000",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MAINEHEALTH BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maine Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.