NPIMap

Individual provider Active NPI

Kathryn M Brouillette, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Portland, ME
National Provider Identifier
1881980332
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
MD20758 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-7060
Fax
(207) 662-7066
NPI assigned
Jun 23, 2011
Last updated
Aug 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Adolescent Medicine (Internal Medicine) Physician 207RA0000X MD20758 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

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

Other names 1

  • Kathryn M Andrews Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002044 ME Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0143456244 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20758MEMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 10, 2015 Accepting new patients
Central Maine Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Nov 10, 2015 Accepting new patients
Maine Medical Partners CurrentSince Apr 1, 2021 Accepting new patients
Maine Street Medical PLLC CurrentSince Oct 17, 2023 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Mainehealth CurrentSince Nov 10, 2015 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Nov 10, 2015 Accepting new patients

Locations

8 Mason St
Brunswick, ME 04011
Phone (207) 578-6608

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

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

22 Bramhall St
Rm 2227
Portland, ME 04102
Phone (207) 662-4618

48 Gilman St
Portland, ME 04102
Phone (207) 661-4400

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

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

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: kathryn.brouillette.1@27919.direct.athenahealth.com
  • Direct secure messaging: kbrouillette9547@direct.mmc.mainehealth.org

Organizations & group practices 11

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1881980332",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-7060",
            "fax_number": "207-662-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "ME",
            "license": "MD20758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "ANDREWS",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.