Active NPI
Kathryn M Brouillette, MD
- Adolescent Medicine (Internal Medicine) Physician
- Portland, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician
- License
- MD20758
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-7060
- Fax
- (207) 662-7066
- NPI assigned
- Jun 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881980332 | Medicaid | ME |
Other names 1
- Kathryn M Andrews
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151203002044 | ME | Practitioner - Internal Medicine | 0143456244 | Reassigns benefits to 6 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mainehealth
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280
Hospital & facility affiliations
- Mainehealth Maine Medical Center
- Mainehealth Mid Coast Hospital
- Lincolnhealth
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MD20758 | ME | MD | Adolescent Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Maine Medical Partners | Current | Accepting new patients | |
| Maine Medical Partners | Current | Accepting new patients | |
| Central Maine Medical Center | Current | Accepting new patients | |
| Maine Medical Partners | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Central Maine Medical Center | Current | Accepting new patients | |
| Maine Medical Partners | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Maine Medical Partners | Current | Accepting new patients | |
| Maine Street Medical PLLC | Current | 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
48 Gilman St
Portland, ME 04102
Phone (207) 661-4400
22 Bramhall St
Rm 2227
Portland, ME 04102
Phone (207) 662-4618
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
- kathryn.brouillette.1@27919.direct.athenahealth.com
- kbrouillette9547@direct.mmc.mainehealth.org
- https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Lewiston, ME
- NPI 1033874458
-
- Surgery Physician
- Scarborough, ME
- NPI 1346687167
-
- Hospitalist Physician
- Portland, ME
- NPI 1942315361
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- General Acute Care Hospital
- Portland, ME
- NPI 1760436216
Hospital & facility affiliations 38
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": "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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1881980332",
"state": "ME"
}
],
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.