Maine Medical Partners Pediatric Specialty Care | |
887 Congress St Suite 320 Portland ME 04102-3100 | |
(207) 662-5522 | |
Not Available |
Full Name | Maine Medical Partners Pediatric Specialty Care |
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Speciality | Pediatrics |
Location | 887 Congress St, Portland, Maine |
Authorized Official Name and Position | Stephen J Kasabian (PRESIDENT) |
Authorized Official Contact | 2076612000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Maine Medical Partners Pediatric Specialty Care 300 Southborough Dr Suite 201 South Portland ME 04106-6914 Ph: (207) 661-2000 | Maine Medical Partners Pediatric Specialty Care 887 Congress St Suite 320 Portland ME 04102-3100 Ph: (207) 662-5522 |
NPI Number | 1992719272 |
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Provider Enumeration Date | 07/29/2006 |
Last Update Date | 12/13/2022 |
Certification Date | 12/13/2022 |
Medicare PECOS PAC ID | 9335043967 |
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Medicare Enrollment ID | O20050901000035 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992719272 | NPI | - | NPPES |
119910028 | Medicaid | ME | |
119910018 | Medicaid | ME | |
119910027 | Medicaid | ME | |
30006478 | Medicaid | NH | |
30216371 | Medicaid | NH | |
119910001 | Medicaid | ME | |
119910019 | Medicaid | ME |
Provider Name | Dana G Crovo |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1871665273 PECOS PAC ID: 0749174415 Enrollment ID: I20040212000325 |
Provider Name | Thomas M Bolles |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1568534089 PECOS PAC ID: 7618861220 Enrollment ID: I20040212000578 |
Provider Name | James V Pisini |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1245302405 PECOS PAC ID: 9537055116 Enrollment ID: I20040223000682 |
Provider Name | Craig S Curry |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1093887408 PECOS PAC ID: 7517856339 Enrollment ID: I20040311000416 |
Provider Name | Stephanie Lash |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1821016650 PECOS PAC ID: 6800874868 Enrollment ID: I20040708000124 |
Provider Name | Heidi L Henninger |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1215938881 PECOS PAC ID: 0749224558 Enrollment ID: I20050613001151 |
Provider Name | Jerrold S Olshan |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1386673382 PECOS PAC ID: 2365487675 Enrollment ID: I20050627000677 |
Provider Name | Leonard C Kaminow |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1548260102 PECOS PAC ID: 3577508704 Enrollment ID: I20050628000234 |
Provider Name | John R Belden |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1194725754 PECOS PAC ID: 9537195300 Enrollment ID: I20050713000151 |
Provider Name | Stephen D Rioux |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1750381398 PECOS PAC ID: 1759318652 Enrollment ID: I20050722000153 |
Provider Name | Paul L Muscat |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1366442923 PECOS PAC ID: 2961435128 Enrollment ID: I20050917000030 |
Provider Name | Georgann S Dickey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669472221 PECOS PAC ID: 9234153685 Enrollment ID: I20060124000832 |
Provider Name | Janice E Dudley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427019694 PECOS PAC ID: 6507872298 Enrollment ID: I20060306000155 |
Provider Name | Tamara Hope Walters Schwartz |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1992751333 PECOS PAC ID: 8123094356 Enrollment ID: I20060426000637 |
Provider Name | Jason A Aucoin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316032824 PECOS PAC ID: 7315957487 Enrollment ID: I20060503000697 |
Provider Name | Robert W Stein |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1194704064 PECOS PAC ID: 4284697996 Enrollment ID: I20070205000203 |
Provider Name | Anna E Furr |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1487773867 PECOS PAC ID: 2163514282 Enrollment ID: I20070822000191 |
Provider Name | Eric Dinnerstein |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1740380153 PECOS PAC ID: 1052403060 Enrollment ID: I20070822001119 |
Provider Name | Joseph T Alexander |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1457331035 PECOS PAC ID: 4880786623 Enrollment ID: I20070823000811 |
Provider Name | Oliver T Fremont |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1730127036 PECOS PAC ID: 0749358596 Enrollment ID: I20081006000681 |
Provider Name | Peter F Morrison |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1407909344 PECOS PAC ID: 4082775960 Enrollment ID: I20081210000693 |
Provider Name | Megan F Selvitelli |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1972552164 PECOS PAC ID: 3678676798 Enrollment ID: I20090131000062 |
Provider Name | Michael A Dedekian |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1093781254 PECOS PAC ID: 5890731277 Enrollment ID: I20090706000290 |
Provider Name | Kenneth A Lombard |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1013946011 PECOS PAC ID: 1355497710 Enrollment ID: I20090926000044 |
Provider Name | Biljana D Beretich |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1609915602 PECOS PAC ID: 4688711567 Enrollment ID: I20091026000508 |
Provider Name | Lisa L Bulthuis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689636607 PECOS PAC ID: 6002942703 Enrollment ID: I20100406000343 |
Provider Name | Katharine E Addicott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013032036 PECOS PAC ID: 6305882044 Enrollment ID: I20100512000451 |
Provider Name | Toni Eimicke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518037910 PECOS PAC ID: 0345318234 Enrollment ID: I20101215001131 |
Provider Name | Vincent Neil Oliviero |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1952399644 PECOS PAC ID: 6204015324 Enrollment ID: I20110121000315 |
Provider Name | Alan H Morris |
---|---|
Provider Type | Practitioner - Other (physician) |
Provider Identifiers | NPI Number: 1427080332 PECOS PAC ID: 5698955375 Enrollment ID: I20110214000069 |
Provider Name | Thomas Q Reynolds |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1811064900 PECOS PAC ID: 3971772732 Enrollment ID: I20110811000588 |
Provider Name | Jane G Morris |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1578600102 PECOS PAC ID: 0749375954 Enrollment ID: I20111007000045 |
Provider Name | Anne W Herrick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437432507 PECOS PAC ID: 2163689209 Enrollment ID: I20120201000766 |
Provider Name | Benjamin F Branch |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1427200534 PECOS PAC ID: 9537210307 Enrollment ID: I20120213000438 |
Provider Name | Alexa K Craig |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1831267798 PECOS PAC ID: 3971752908 Enrollment ID: I20121005000354 |
Provider Name | Pamela Pahel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851641823 PECOS PAC ID: 7315199197 Enrollment ID: I20121129000457 |
Provider Name | Margaretta G Byrne |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851643548 PECOS PAC ID: 9537311501 Enrollment ID: I20121221000082 |
Provider Name | Christine Lu-emerson |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1336254259 PECOS PAC ID: 8527225903 Enrollment ID: I20121228000446 |
Provider Name | Michael S Kleinman |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1588839773 PECOS PAC ID: 1456593169 Enrollment ID: I20130808000799 |
Provider Name | Colby A Wyatt |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1073788956 PECOS PAC ID: 0345483475 Enrollment ID: I20130821000443 |
Provider Name | Thomas S Savadove |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1801918685 PECOS PAC ID: 7911057989 Enrollment ID: I20130920000566 |
Provider Name | Diana T Page |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750613048 PECOS PAC ID: 2163559857 Enrollment ID: I20131007001173 |
Provider Name | Alana M Rose |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083056253 PECOS PAC ID: 6800021460 Enrollment ID: I20131107000168 |
Provider Name | Jaime A Eller |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1932521085 PECOS PAC ID: 1557593423 Enrollment ID: I20140408000052 |
Provider Name | David J Chalmers |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1669665196 PECOS PAC ID: 9931342177 Enrollment ID: I20140711000244 |
Provider Name | Maxine C Guay |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871917138 PECOS PAC ID: 9335360833 Enrollment ID: I20141027001980 |
Provider Name | George H Russell |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1366423154 PECOS PAC ID: 6305882754 Enrollment ID: I20160415001534 |
Provider Name | Diana J Goodman |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1245457514 PECOS PAC ID: 7113182866 Enrollment ID: I20160418000382 |
Provider Name | Benjamin C Winkler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750510772 PECOS PAC ID: 6002942646 Enrollment ID: I20160517002382 |
Provider Name | Sarah A Dodwell |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1184910697 PECOS PAC ID: 5597058024 Enrollment ID: I20160721000960 |
Provider Name | Noah J.f. Hoffman |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1790097053 PECOS PAC ID: 1355634767 Enrollment ID: I20160722001027 |
Provider Name | Jason A Helis |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1114215043 PECOS PAC ID: 7719272830 Enrollment ID: I20160827000363 |
Provider Name | Anton M Kurtz |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1619101219 PECOS PAC ID: 4981990363 Enrollment ID: I20160912000703 |
Provider Name | Mark J Gorman |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1891765418 PECOS PAC ID: 0042224099 Enrollment ID: I20161018000238 |
Provider Name | Elizabeth Mckenna |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1336696285 PECOS PAC ID: 2961783683 Enrollment ID: I20170111001193 |
Provider Name | Raven R Fulford |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1760927347 PECOS PAC ID: 4688956857 Enrollment ID: I20170124000150 |
Provider Name | Sophie R. Herr |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548704026 PECOS PAC ID: 8729360904 Enrollment ID: I20170124000339 |
Provider Name | Lisa Murray |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326583436 PECOS PAC ID: 0446532626 Enrollment ID: I20170124000368 |
Provider Name | Caroline M Chaloner |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1578008157 PECOS PAC ID: 5698057883 Enrollment ID: I20170124000971 |
Provider Name | Brandy M Brown |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255877239 PECOS PAC ID: 7012291834 Enrollment ID: I20170222002559 |
Provider Name | Jessica Yocz |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1285171959 PECOS PAC ID: 8224312996 Enrollment ID: I20170223001645 |
Provider Name | Mark L Mcallister |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1295050755 PECOS PAC ID: 0244544609 Enrollment ID: I20170613001116 |
Provider Name | David H Taplinger |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1427347012 PECOS PAC ID: 4486882263 Enrollment ID: I20170823003526 |
Provider Name | Evdokia Eleftheriou |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1346504545 PECOS PAC ID: 9436456662 Enrollment ID: I20170829003626 |
Provider Name | Allison M Caldwell |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1881031904 PECOS PAC ID: 9234358326 Enrollment ID: I20170908000088 |
Provider Name | Donna J Bisbee |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1669979522 PECOS PAC ID: 8224393723 Enrollment ID: I20180605000396 |
Provider Name | Nathan J Leu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386602290 PECOS PAC ID: 7810993219 Enrollment ID: I20180829003790 |
Provider Name | Aimee D Reilly |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881172476 PECOS PAC ID: 0840542734 Enrollment ID: I20181003002610 |
Provider Name | Ross Feller |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1265725493 PECOS PAC ID: 1254551963 Enrollment ID: I20181130002179 |
Provider Name | Gretchen Schoenfield |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1356603807 PECOS PAC ID: 5890943799 Enrollment ID: I20191015003315 |
Provider Name | Sarah Stone |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1972921682 PECOS PAC ID: 7315241882 Enrollment ID: I20191021002520 |
Provider Name | Kelly J Baldwin |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1467695437 PECOS PAC ID: 7618101429 Enrollment ID: I20200805001926 |
Provider Name | Kathryn P Brooks |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1053885277 PECOS PAC ID: 0840605937 Enrollment ID: I20210223002721 |
Provider Name | Benjamin J Shore |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1992027213 PECOS PAC ID: 9931393931 Enrollment ID: I20210308000552 |
Provider Name | Grant D Hogue |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1619107349 PECOS PAC ID: 9638480775 Enrollment ID: I20210308002243 |
Provider Name | Craig M Birch |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1104263565 PECOS PAC ID: 9436402500 Enrollment ID: I20210308002599 |
Provider Name | Colyn J Watkins |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1568728244 PECOS PAC ID: 1951539923 Enrollment ID: I20210309002275 |
Provider Name | Katherine M Kalagias |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1588117022 PECOS PAC ID: 9638465768 Enrollment ID: I20210311001385 |
Provider Name | Rachel Baird |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245671205 PECOS PAC ID: 8022419951 Enrollment ID: I20210629001686 |
Provider Name | Lydia Sommer |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1073966891 PECOS PAC ID: 4486041423 Enrollment ID: I20220421002511 |
Provider Name | Kaitlyn E Anderson |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1225624828 PECOS PAC ID: 8729465737 Enrollment ID: I20220512002395 |
Provider Name | Tiffani L Mcdonough |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1972764819 PECOS PAC ID: 0143447185 Enrollment ID: I20220913000596 |
Provider Name | Lily C Wang |
---|---|
Provider Type | Practitioner - Urology |
Provider Identifiers | NPI Number: 1487979878 PECOS PAC ID: 6901142686 Enrollment ID: I20221010000533 |
Provider Name | Catherine Monigan |
---|---|
Provider Type | Practitioner - Neuropsychiatry |
Provider Identifiers | NPI Number: 1508386384 PECOS PAC ID: 5597011254 Enrollment ID: I20221026000938 |
Provider Name | Stuart V Braun |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1013946516 PECOS PAC ID: 8921068925 Enrollment ID: I20221206002469 |
Provider Name | Benjamin J Drapcho |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1124523337 PECOS PAC ID: 1456600618 Enrollment ID: I20230703001213 |
Provider Name | Jacob Morgan Stout |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1184111916 PECOS PAC ID: 0941552988 Enrollment ID: I20230710001381 |
Provider Name | Eileena J Newton |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1275996407 PECOS PAC ID: 6507125598 Enrollment ID: I20230807000189 |
Provider Name | Deepti Virmani |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1790224426 PECOS PAC ID: 9739430158 Enrollment ID: I20230918002482 |
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