Jacob Patrick Leidholm, CNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

CNP231268 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-4618

Fax

(207) 662-6254

NPI assigned

Nov 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score

86.22 of 100Reported as group

Quality

75.39

Promoting interoperability

84

Improvement activities

40

Cost

75.32

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment Care Compare group NPD
• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment Care Compare group
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • Family Medicine Physician
  • Scarborough, ME
  • NPI 1497068969
  NPD

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1922765197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        },
        {
            "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": "207-662-4618",
            "fax_number": "207-662-6254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7937",
            "fax_number": "207-283-7018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 June St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732621",
            "country_code": "US",
            "telephone_number": "207-324-4310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIDHOLM",
        "first_name": "JACOB",
        "middle_name": "PATRICK",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-23",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2361554",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2361554",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP231268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Legit Home Care LLC
• David Lehman, DO
• Elise Lehotsky, LCSW
• Sally Ann Lehtinen, MASSAGE THERAPIST
• Stanley Leiberman
• Alexandra Elizabeth Leighton, LMT
• Robert Dennis Leighton, P.T.
• Austin Richard Leise, MD
• Joan Schaap Leitzer, M.D.
• Christopher Lekousi

• Acute Care Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Acute Care Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.

Verify at the official NPI Registry.