Individual provider Active NPI

Doreen M Kendall, D. O.

  • Family Medicine Physician
  • Rockport, ME
National Provider Identifier
1821233230
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2212 Issued in ME
Practice address
1112 Commercial St
Rockport, ME 04856-3802
Phone
(207) 236-2169
Fax
(207) 230-0413
NPI assigned
Dec 15, 2008
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2212 ME
Family Medicine Physician 207Q00000X 2212 ME Primary

Addresses

Primary practice location

1112 Commercial St
Rockport, ME 04856-3802

Mailing address

PO Box 1079
Midcoast Medicine, PA
Rockport, ME 04856-1079
Phone (207) 236-2169

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110511000557 ME Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9133267214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midcoast Medicine and Wellness PCGroup PAC ID 5395046114, 2 clinicians

Practice addresses (Care Compare)

1112 Commercial St
Rockport, ME 04856-3802
Phone (207) 236-2169

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Midcoast Medicine & Wellness, PC Family Medicine CurrentSince Oct 6, 2015 Accepting new patients
Access Pronto Family Medicine P a Family Medicine Past Accepting new patients

Locations

5 Mountain St
Camden, ME 04843
Phone (207) 236-2169

1112 Commercial St
Rockport, ME 04856
Phone (207) 236-2169

Interoperability endpoints

  • Direct secure messaging: doreen.kendall.1@11806.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11806/brand/1/csg/1/fhir/r4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1821233230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1079",
            "address_2": "MIDCOAST MEDICINE, PA",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048561079",
            "telephone_number": "207-236-2169",
            "fax_number": "207-230-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 COMMERCIAL ST",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563802",
            "telephone_number": "207-236-2169",
            "fax_number": "207-230-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "DOREEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "2212",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "2212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.