Organization Active NPI

Oa ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Portland, ME
National Provider Identifier
1811718521
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
OA ASC LLC
Practice address
33 Sewall St
Portland, ME 04102-2603
Phone
(207) 828-2101
Fax
(207) 553-7166
NPI assigned
Oct 24, 2024
Organization subpart
Yes
Parent organization
GROWTH ORTHOPEDICS SERVICES MSOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Kathryn H Hanna, MDNPI 1063575355
Title
Vice President
Phone
(207) 828-2101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

33 Sewall St
Portland, ME 04102-2603

Mailing address

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250328002165 ME Part B Supplier - Ambulatory Surgical Center 2264955301 Practice locations: Portland, ME

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0877265Oa ASC, LLC33 Sewall Street, Portland, ME 04102Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Locations

2811 Ponce de Leon Blvd
Ste 400
Coral Gables, FL 33134

33 Sewall St
Ste 1
Portland, ME 04102

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1811718521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2101",
            "fax_number": "207-553-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2101",
            "fax_number": "207-553-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OA ASC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROWTH ORTHOPEDICS SERVICES MSO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "207-828-2101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "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 Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.