NPIMap

Organization Active NPI

Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Portland, ME
National Provider Identifier
1861183303
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CONVENIENTMD - FFS UC LLC
Practice address
191 Marginal Way
Portland, ME 04101-3387
Phone
(207) 517-3838
NPI assigned
May 16, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Jarod Boissonneault
Title
VP, Revenue Cycle MGT
Phone
(603) 410-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

191 Marginal Way
Portland, ME 04101-3387

Mailing address

111 NH Ave
Portsmouth, NH 03801-2864
Phone (603) 410-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230803000124 ME Part B Supplier - Clinic/Group Practice 5193186492 Receives reassigned benefits from 167 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, ME; Westbrook, ME; Sanford, ME; Saco, ME; Farmington, ME; Ellsworth, ME; Brunswick, ME; Belfast, ME…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1861183303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NH AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012864",
            "telephone_number": "603-410-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013387",
            "telephone_number": "207-517-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENTMD - FFS UC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "BOISSONNEAULT",
        "authorized_official_first_name": "JAROD",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE MGT",
        "authorized_official_telephone_number": "603-410-6700"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "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 Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.