U.S. Healthworks Medical Group of Maine, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

U.S. HEALTHWORKS MEDICAL GROUP OF MAINE, INC.

Practice address

11 Medical Center Dr
Brunswick, ME 04011-2690

Phone

(207) 725-2697

Fax

(207) 729-4719

NPI assigned

Oct 3, 2016

Last updated

Oct 3, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. HEALTHWORKS MEDICAL GROUP OF MAINE, INC.As reported in NPPES

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

Authorized official

Name

Mr. Joseph T Mallas

Title

President & Cheif Executive Officer

Phone

(661) 678-2600

Specialties & licenses 2

Addresses

Tax ID family

U S Healthworks Medical3 organizations share this tax ID, including this one

Part of

U S Healthworks Medical

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• U.S. Healthworks Medical Group of Maine, Inc.

  • Urgent Care Clinic/Center
  • South Portland, ME
  • NPI 1205385143
  NPD tax ID
• U.S. Healthworks Medical Group of Maine, Inc.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Valencia, CA
  • NPI 1194705764
  NPD tax ID

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1821547860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25124 SPRINGFIELD CT",
            "address_2": "200",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551085",
            "telephone_number": "661-678-2600",
            "fax_number": "661-678-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112690",
            "telephone_number": "207-725-2697",
            "fax_number": "207-729-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U.S. HEALTHWORKS MEDICAL GROUP OF MAINE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. HEALTHWORKS MEDICAL GROUP OF MAINE, INC.",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "MALLAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT & CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "661-678-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin C. Tyau, PA-C
• Kimberly Tycz, PT
• Matthew Tycz, MSPT
• Tiffany Irena Tyler-Bisson
• Irene Turcotte Tyler, LCSW
• Roople Kiran Unia, MD
• Heather Valliere, M.S. CCC-SLP
• Sebastian D Van Dyck, DPT
• John S Van Orden, MD
• Stephen R Vance, PT, CHT

• Urgent Care Clinic/Center in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Urgent Care Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.