NPIMap

Individual provider Active NPI

Marc Calabrese, M.D.

  • Urology Physician
  • South Portland, ME
National Provider Identifier
1942614979
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD23704 Issued in ME
Practice address
21 Donald B Dean Dr Ste 1
South Portland, ME 04106-3234
Phone
(207) 518-6600
Fax
(207) 541-7445
NPI assigned
Jun 18, 2014
Last updated
Jul 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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 259031 MA
Urology Physician 208800000X MD23704 ME Primary

Addresses

Primary practice location

21 Donald B Dean Dr Ste 1
South Portland, ME 04106-3234

Mailing address

21 Donald B Dean Dr Ste 1
South Portland, ME 04106-3234
Phone (207) 518-6600

Other practice location 1

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8585

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
I20200707001234 ME Practitioner - Urology 0941623151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fore River Urology LLCGroup PAC ID 5799911566, 10 clinicians

Practice addresses (Care Compare)

21 Donald B Dean Dr
Suite 1
South Portland, ME 04106-3252
Phone (207) 518-6617

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
259031MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Fore River Urology LLC Urology CurrentSince Aug 1, 2020 Accepting new patients

Locations

21 Donald B Dean Dr
#1
South Portland, ME 04106
Phone (207) 518-6617

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7607/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marc.calabrese.1@7607.direct.athenahealth.com

Organizations & group practices 1

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1942614979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DONALD B DEAN DR STE 1",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063234",
            "telephone_number": "207-518-6600",
            "fax_number": "207-541-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DONALD B DEAN DR STE 1",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063234",
            "telephone_number": "207-518-6600",
            "fax_number": "207-541-7445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018050001",
            "country_code": "US",
            "telephone_number": "781-744-8585",
            "fax_number": "781-744-3646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "259031",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "MD23704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.