Active NPI
Mikhail Kushnarev, MD
- Anesthesiology Physician
- Portland, ME
National Provider Identifier
1790338671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD27545
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 482-7800
- Fax
- (207) 482-7898
- NPI assigned
- Jul 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 125.075014 | IL | |
| Pediatric Anesthesiology Physician | 207LP3000X | 3013623 | MA | |
| Anesthesiology Physician | 207L00000X | MD27545 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800
Other practice location 1
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600
Other practice location 2
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
35 Mile St
Damariscotta, ME 04543-4047
Phone (207) 563-4146
Hospital & facility affiliations
- Mainehealth Maine Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.075014 | IL | MD | Anesthesiology Physician |
| 3013623 | MA | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Healthcare Partners, P.a. | Current | Accepting new patients | |
| Spectrum Healthcare Partners, P.a. | Anesthesiology | Current | Accepting new patients |
Locations
35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
324 Gannett Dr
Ste 200
South Portland, ME 04106
Phone (207) 482-7861
Interoperability endpoints
- mkushnarev36543@direct.bostonchildrens.org
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Portland, ME
- NPI 1245252212
-
- Anatomic Pathology & Clinical Pathology Physician
- Portland, ME
- NPI 1386757607
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1790338671",
"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": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023134",
"telephone_number": "207-482-7800",
"fax_number": "207-482-7898"
}
],
"practiceLocations": [
{
"address_1": "836 W Wellington Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575147",
"country_code": "US",
"telephone_number": "773-975-1600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Longwood Ave",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021155724",
"country_code": "US",
"telephone_number": "617-355-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUSHNAREV",
"first_name": "MIKHAIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-19",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "125.075014",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "MA",
"license": "3013623",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ME",
"license": "MD27545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.