Individual provider Active NPI

Mark T Branda, MD

  • Gastroenterology Physician
  • Lewiston, ME
National Provider Identifier
1861619058
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD17628 Issued in ME
Practice address
77 Bates St
Suite 200
Lewiston, ME 04240
Phone
(207) 784-5784
Fax
(207) 784-1477
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X LP00462 RI
Gastroenterology Physician 207RG0100X MD17628 ME Primary

Addresses

Primary practice location

77 Bates St
Suite 200
Lewiston, ME 04240

Mailing address

6451 N Federal Hwy Ste 700
Fort Lauderdale, FL 33308-1420
Phone (855) 808-2723

Other practice location 1

121 Medical Center Dr Ste 3400
Brunswick, ME 04011-2675
Phone (207) 406-7300

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
I20080917000194 ME Practitioner - Gastroenterology 3476620485 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Vermont College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

121 Medical Ctr Dr
Suite 3400
Brunswick, ME 04011-2675
Phone (207) 406-7300

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy50
Upper gastrointestinal (GI) endoscopy for acid reflux63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP00462RIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Mar 3, 2025 Accepting new patients
Mainehealth CurrentSince Mar 3, 2025 Accepting new patients
Rumford Hospital CurrentSince Apr 1, 2011 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Jan 9, 2023 Accepting new patients
Rumford Hospital CurrentSince Apr 1, 2011 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Jan 9, 2023 Accepting new patients
St. Mary'S Regional Medical Center Current Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

121 Medical Center Dr
Ste 3400
Brunswick, ME 04011
Phone (207) 406-7300

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

77 Bates St
Ste 200
Lewiston, ME 04240
Phone (207) 784-5784

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

329 Maine St
Mere Point, ME 04011
Phone (207) 373-2250

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • Direct secure messaging: mbranda237827@direct.mmc.mainehealth.org
  • Direct secure messaging: mbranda1401902@direct.bsmhealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1861619058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 N FEDERAL HWY STE 700",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081420",
            "telephone_number": "855-808-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BATES ST",
            "address_2": "SUITE 200",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-784-5784",
            "fax_number": "207-784-1477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Medical Center Dr Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112675",
            "country_code": "US",
            "telephone_number": "207-406-7300",
            "fax_number": "207-835-4736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDA",
        "first_name": "MARK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "RI",
            "license": "LP00462",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD17628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.