NPIMap

Organization Active NPI

Maine Medical Partners

Doing business as Maine Medical Partners Otolaryngology

  • Otolaryngology Physician
  • Scarborough, ME
National Provider Identifier
1881908879
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MAINE MEDICAL PARTNERS
Doing business as
Maine Medical Partners Otolaryngology
Practice address
92 Campus Drive
3Rd Floor
Scarborough, ME 04074
Phone
(207) 797-5753
Fax
(207) 797-9571
NPI assigned
Aug 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Donna Jauregui
Title
Dir-Prvdr Enrollment & Cvo, MHMG PA
Phone
(207) 661-5414

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0007X
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

92 Campus Drive
3Rd Floor
Scarborough, ME 04074

Mailing address

300 Southborough Dr
Suite 201
South Portland, ME 04106-6914
Phone (207) 661-2000

Other names 1

  • Maine Medical Partners Otolaryngology Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330000128 ME Part B Supplier - Clinic/Group Practice 9335043967 Receives reassigned benefits from 72 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norway, ME; Waterville, ME; Scarborough, ME; Portland, ME; Lewiston, ME; Bridgton, ME; Biddeford, ME

Other NPIs on the same Medicare enrollment 1

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

  • Maine Medical Partners

    dba Maine Medical Partners Endocrinology & Diabetes Center

    • Endocrinology, Diabetes & Metabolism Physician
    • Scarborough, ME
    • NPI 1447354899

    O20040330000128

    Same enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1881908879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTHBOROUGH DR",
            "address_2": "SUITE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-661-2000",
            "fax_number": "207-661-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DRIVE",
            "address_2": "3RD FLOOR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MEDICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "JAUREGUI",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIR-PRVDR ENROLLMENT & CVO, MHMG PA",
        "authorized_official_telephone_number": "207-661-5414"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Maine Medical Partners Otolaryngology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maine Medical Partners Otolaryngology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.