Hospice of Southern Maine

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

36152 Issued in ME

Legal business name

HOSPICE OF SOUTHERN MAINE

Practice address

390 US Route 1
Scarborough, ME 04074-9772

Phone

(207) 289-3640

Fax

(207) 883-1040

NPI assigned

Nov 4, 2005

Organization subpart

No

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

Authorized official

Name

Michelle Malo

Title

Quality & Compliance Director

Phone

(207) 289-3640

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Hospice certification: CCN 201511

Legal name

HOSPICE OF SOUTHERN MAINE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 4, 1995

Last certification

Aug 4, 2022

Ownership / control type

Non-Profit - Private

Organization structure

CorporationNon-profit

Incorporated

May 15, 2003 in ME

Enrollment address

390 US Route 1
Scarborough, ME 04074-9772

Listed as

Andwell Health PartnersCCN 201511

Ownership

Non-Profit

Certified

Jan 4, 1995

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Fernando Moreno Jr., MD

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Portland, ME
  • NPI 1154636280

  Contracted Managing Employee, Corporate Director

  CMS ownership
• Nathan E Wilson, M.D.

  • Internal Medicine Physician
  • Biddeford, ME
  • NPI 1376500314

  Corporate Director

  CMS ownership
• Mark A Wrona, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Westbrook, ME
  • NPI 1003909565

  Corporate Director

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colette Marie Beaumont, RNNP

  • Family Nurse Practitioner
  • Scarborough, ME
  • NPI 1790834588
  NPD (past)
• Cynthia M Burnham, DO

  • Psychiatry Physician
  • Saco, ME
  • NPI 1740327162
  NPD (past)
• Lauren G Michalakes, MD

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1093850059
  NPD (past)

Affiliated clinicians 91

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• George E Abboud, MD

  • Internal Medicine Physician
  • Biddeford, ME
  • NPI 1376612945

  Hospice

  Care Compare affiliation
• Justine Marie Achille, MD

  • Family Medicine Physician
  • Gorham, ME
  • NPI 1962962324

  Hospice

  Care Compare affiliation
• Todd M Adams, MD

  • Internal Medicine Physician
  • Moody, ME
  • NPI 1427165778

  Hospice

  Care Compare affiliation
• Michael Emanuel Auster, DO

  • Hematology & Oncology Physician
  • South Portland, ME
  • NPI 1164929451

  Hospice

  Care Compare affiliation
• Evan Barnathan, M.D.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1558773994

  Hospice

  Care Compare affiliation
• Douglas R Barr, MD

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1134180359

  Hospice

  Care Compare affiliation
• Kristen Baum

  • Internal Medicine Physician
  • Biddeford, ME
  • NPI 1538797576

  Hospice

  Care Compare affiliation
• Jessica J Bian, M.D.

  • Medical Oncology Physician
  • South Portland, ME
  • NPI 1821435140

  Hospice

  Care Compare affiliation
• Mark Braun, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Scarborough, ME
  • NPI 1851327936

  Hospice

  Care Compare affiliation
• Teresa Breault, MD

  • Family Medicine Physician
  • North Berwick, ME
  • NPI 1447211073

  Hospice

  Care Compare affiliation
• Kathleen Elizabeth Brennan, M.D.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1922444900

  Hospice

  Care Compare affiliation
• Anthony J. Bustamante, M.D.

  • Family Medicine Physician
  • Yarmouth, ME
  • NPI 1306229521

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1972594232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749772",
            "telephone_number": "207-289-3640",
            "fax_number": "207-883-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749772",
            "telephone_number": "207-289-3640",
            "fax_number": "207-883-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF SOUTHERN MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "MALO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "QUALITY & COMPLIANCE DIRECTOR",
        "authorized_official_telephone_number": "207-289-3640"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "ME",
            "license": "36152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Hodge, OT
• Sara M Hoffman, PA-C
• Deirdre G. Hogan, LCSW
• Kristen Lynn Honsinger, MD
• Nancy A Horgan, PT
• Loretta A Hothersall, FNP
• Mary Elizabeth Hourihan, M.D.
• Lisa Peter Howard, DDS, MS
• Alexander V Hoyt, SLP
• Blair Eugene Hudson-Fridgen, D.C.

• All providers in Scarborough, ME
• Community Based Hospice Care Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.