Maryann Elizabeth Walsh, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD13386 Issued in ME

Practice address

234 State St
Brewer, ME 04412-1519

Phone

(207) 989-5005

Fax

(207) 989-0551

NPI assigned

Aug 31, 2005

Last updated

Jul 25, 2014By the provider in NPPES

Sex

Female

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

Other names 1

• Maryann Elizabeth Kradzinski Former name

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health and Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1457415184
  Medicare reassignment NPD
• Community Health and Counseling Services

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1508921842
  NPD
• Alternative Health Services of St. Joseph Inc.

  dba St. Joseph Homecare and Hospice

  • Home Health Agency
  • Bangor, ME
  • NPI 1972503365
  NPD (past)
• Norumbega Medical Specialists, LTD

  • Health Service Clinic/Center
  • Brewer, ME
  • NPI 1780821140
  NPD (past)
• St. Joseph Ambulatory Care Inc

  dba St. Joseph Infusion Center

  • Medical Specialty Clinic/Center
  • Bangor, ME
  • NPI 1184678088
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1811980204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121021",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 STATE ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121519",
            "telephone_number": "207-989-5005",
            "fax_number": "207-989-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MARYANN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD13386",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD13386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "041154",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225860099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "KRADZINSKI",
            "middle_name": "ELIZABETH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-5076)
• Wal-Mart Stores East, LP (Vision Center 30-5076)
• Walgreen Co (Rite Aid #17452)
• Walgreen Eastern Co Inc (Walgreens #11545)
• Maryalice Walker, NP-C
• Kathryn O Ward, OD
• Braylee Wardwell
• Kristen Marie Waskewicz, FNP
• Kaitlyn R. Weaver, COTA/L
• Kristene Welch, PHARMD

• Internal Medicine Physician in Brewer, ME
• Providers in Brewer, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.