Individual provider Active NPI

Logan Y Murray, MD

  • Pediatrics Physician
  • Portland, ME
National Provider Identifier
1942377999
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
018131 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102
Phone
(207) 662-2541
Fax
(207) 662-3172
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 018131 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102

Mailing address

149 Main St
Ste 1a
Winthrop, ME 04364-1486
Phone (207) 377-2114

Other identifiers 1

IdentifierTypeStateIssuer
435193199MedicaidME

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
I20100814000154 ME Practitioner - Pediatric Medicine 8123152063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Vermont College of Medicine, 2006
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018131MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center Pediatrics CurrentSince Jul 8, 2010 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jul 22, 2012 Accepting new patients
Mainehealth CurrentSince Jul 22, 2012 Accepting new patients
Mainegeneral Medical Center CurrentSince Jul 8, 2010 Accepting new patients
Mainegeneral Medical Center Past Accepting new patients
Mainehealth Past Accepting new patients
Mainehealth Pediatrics Past Accepting new patients

Locations

442 Civic Center Dr
Augusta, ME 04330
Phone (207) 622-6319

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

4 Shape Dr
Kennebunk, ME 04043
Phone (207) 467-8988

22 Bramhall St
#C
Portland, ME 04102

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

149 Main St
Ste 1A
Winthrop, ME 04364
Phone (207) 377-2114

Interoperability endpoints

  • Direct secure messaging: lmurray31177@direct.mmc.mainehealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1942377999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 MAIN ST",
            "address_2": "STE 1A",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043641486",
            "telephone_number": "207-377-2114",
            "fax_number": "207-377-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-2541",
            "fax_number": "207-662-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "LOGAN",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "018131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435193199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.