Mark J Integlia, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

015427 Issued in ME

Practice address

887 Congress St
Suite 410B
Portland, ME 04102-3100

Phone

(207) 662-5522

Fax

(207) 662-5526

NPI assigned

Jul 6, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935

  NH

  Medicare reassignment NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD (past)
• Maine Medical Partners

  • Pediatric Gastroenterology Physician
  • Portland, ME
  • NPI 1992719272

  Pediatric Gastroenterology

  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1790717312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 410B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-662-5522",
            "fax_number": "207-662-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTEGLIA",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "015427",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "ME",
            "license": "015427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283380099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201387",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tristan Ingram
• Veronica Ingrao, LCSW, LICSWLADC, CCS
• Lowell F. Inhorn, M.D.
• Madeline Inlow
• Inspire Health Services LLC
• Integrated Behavioral Healthcare
• Integrative Therapies for Cancer & Chronic Disease Inc
• Interbloom Therapy Center
• Intermed, PA
• Intermed, PA

• All providers in Portland, ME
• Pediatric Gastroenterology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.