NPIMap

Individual provider Active NPI

Jill Marie Kerekes, M.D.

  • Internal Medicine Physician
  • Windham, ME
National Provider Identifier
1992728323
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD17649 Issued in ME
Practice address
584 Roosevelt TRL
Windham, ME 04062-7302
Phone
(207) 892-3233
Fax
(207) 893-0752
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD17649 ME Primary
Pediatrics Physician 208000000X MD17649 ME

Addresses

Primary practice location

584 Roosevelt TRL
Windham, ME 04062-7302

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other identifiers 3

IdentifierTypeStateIssuer
200802OtherMEANTHEM
30208309MedicaidNH
432827099MedicaidME

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
I20080225000138 ME Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6507897907 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Ohio State University College of Medicine, 2001
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) 885-9905

582 Roosevelt TRL
Windham, ME 04062-4904
Phone (207) 892-3233

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Portland, ME, CCN 207073
  • Andwell Health Partners Hospice, Scarborough, ME, CCN 201511
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008
  • Bridgton Hospital Hospital, Bridgton, ME, CCN 201310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17649MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners Internal Medicine CurrentSince Apr 1, 2012 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2010 Accepting new patients
Maine Medical Partners Internal Medicine CurrentSince Mar 1, 2008 Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Apr 1, 2012 Accepting new patients
Maine Medical Partners CurrentSince Apr 1, 2012 Accepting new patients
Mainehealth Internal Medicine CurrentSince Oct 1, 2010 Accepting new patients
Maine Medical Partners CurrentSince Mar 1, 2008 Accepting new patients
Primecare Physician Associates Internal Medicine Past Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients
Mainehealth Past Accepting new patients
Alternative Wellness Services PastSince Dec 7, 2018 Accepting new patients

Locations

9 Healthcare Dr
Ste 201
Biddeford, ME 04005
Phone (207) 282-9080

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

9 Healthcare Dr
Ste 101
Biddeford, ME 04005
Phone (207) 282-4270

9 Healthcare Dr
Ste 202
Biddeford, ME 04005
Phone (207) 283-1427

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

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

582 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3233

Interoperability endpoints

  • Direct secure messaging: jkerekes1297@direct.mmc.mainehealth.org

Organizations & group practices 12

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.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1992728323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040627302",
            "telephone_number": "207-892-3233",
            "fax_number": "207-893-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEREKES",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD17649",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD17649",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "200802",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30208309",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432827099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

Verify at the official NPI Registry.