| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 19 West St, Portland, Maine |
| Authorized Official Name and Position | Lugene Anthony Inzana (SVP FINANCE/CFO) |
| Authorized Official Contact | 2076623538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
301 Us Route 1 Building C Scarborough ME 04074-7609 Ph: (207) 396-8600 | 19 West St Portland ME 04102 Ph: (207) 662-7180 |
| NPI Number | 1780788372 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 7517860588 |
|---|---|
| Medicare Enrollment ID | O20040331000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780788372 | NPI | - | NPPES |
| 102500201 | Medicaid | ME | |
| 30212545 | Medicaid | NH |
| Provider Name | James F Whiting |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205812070 PECOS PAC ID: 3173428588 Enrollment ID: I20031126000605 |
| Provider Name | Paul W Sweeney |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073583522 PECOS PAC ID: 5597659219 Enrollment ID: I20040214000089 |
| Provider Name | Mark G Parker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770583346 PECOS PAC ID: 0042107690 Enrollment ID: I20040301000156 |
| Provider Name | Nicole Cherbuliez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932293578 PECOS PAC ID: 0840277455 Enrollment ID: I20040701000907 |
| Provider Name | Lynette J Weeman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275588261 PECOS PAC ID: 0840270245 Enrollment ID: I20040726000330 |
| Provider Name | David T Frost |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639159064 PECOS PAC ID: 5294705158 Enrollment ID: I20040728000767 |
| Provider Name | Richard T Marino |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1285665828 PECOS PAC ID: 1557332665 Enrollment ID: I20040803000815 |
| Provider Name | Susan Miesfeldt |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1043281959 PECOS PAC ID: 4587631635 Enrollment ID: I20040916000807 |
| Provider Name | Heidi R. Wierman |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1699868158 PECOS PAC ID: 4587613005 Enrollment ID: I20050121000334 |
| Provider Name | Christine M Freme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225123524 PECOS PAC ID: 6507807674 Enrollment ID: I20050518001203 |
| Provider Name | Stuart Abramson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821097148 PECOS PAC ID: 2567404015 Enrollment ID: I20050525000697 |
| Provider Name | Heinrich H Grube |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003885708 PECOS PAC ID: 6901840750 Enrollment ID: I20050614000134 |
| Provider Name | James C Wasserman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457352874 PECOS PAC ID: 1557307766 Enrollment ID: I20050628000954 |
| Provider Name | Paul A Parker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649278029 PECOS PAC ID: 9638115546 Enrollment ID: I20050630000784 |
| Provider Name | Patricia L Cantlin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1275533994 PECOS PAC ID: 4183652985 Enrollment ID: I20050802001147 |
| Provider Name | John P Vella |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255332698 PECOS PAC ID: 8224066857 Enrollment ID: I20050803000807 |
| Provider Name | John T Devlin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1770686800 PECOS PAC ID: 1557392636 Enrollment ID: I20050829000502 |
| Provider Name | Michael C Akom |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508827585 PECOS PAC ID: 3577580604 Enrollment ID: I20051028000169 |
| Provider Name | Deborah Ann Hoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154449759 PECOS PAC ID: 3971518416 Enrollment ID: I20060220000526 |
| Provider Name | Colleen M O Connor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912916321 PECOS PAC ID: 4183723950 Enrollment ID: I20070619000536 |
| Provider Name | Robert J Fraser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134206352 PECOS PAC ID: 2466543103 Enrollment ID: I20070809000238 |
| Provider Name | David A Polisner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013080852 PECOS PAC ID: 1557362191 Enrollment ID: I20071003000035 |
| Provider Name | Thomas M Morrione |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1841367943 PECOS PAC ID: 4385727692 Enrollment ID: I20080211000125 |
| Provider Name | Wenzel D Kovarik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063584274 PECOS PAC ID: 6608942768 Enrollment ID: I20080915000191 |
| Provider Name | Trisha L Warren Vanhorn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124289939 PECOS PAC ID: 7911068374 Enrollment ID: I20081210000032 |
| Provider Name | Sarah A M Hallen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033221817 PECOS PAC ID: 2860548849 Enrollment ID: I20090916000162 |
| Provider Name | Dena L Whitesell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659449320 PECOS PAC ID: 0042357717 Enrollment ID: I20091029000077 |
| Provider Name | Eric N Taylor |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1780776724 PECOS PAC ID: 8628015526 Enrollment ID: I20091216000421 |
| Provider Name | Ioan M Cosma |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356540454 PECOS PAC ID: 8729102751 Enrollment ID: I20100827000732 |
| Provider Name | Ana Rossi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629277710 PECOS PAC ID: 2264613330 Enrollment ID: I20110222001003 |
| Provider Name | Emily V Wood |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1093884710 PECOS PAC ID: 6507037470 Enrollment ID: I20110926000613 |
| Provider Name | Kristine M Pleacher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891976098 PECOS PAC ID: 8325116601 Enrollment ID: I20111216000365 |
| Provider Name | Paul F Frey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235351669 PECOS PAC ID: 0244321222 Enrollment ID: I20120907000515 |
| Provider Name | Samantha L Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568598779 PECOS PAC ID: 1052561438 Enrollment ID: I20121019000440 |
| Provider Name | Rachael Y Blake |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1831357839 PECOS PAC ID: 7113177429 Enrollment ID: I20121023000324 |
| Provider Name | Julia M Redding |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1932367034 PECOS PAC ID: 6406007293 Enrollment ID: I20121102000234 |
| Provider Name | Ann K Magner |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1205060225 PECOS PAC ID: 5395988505 Enrollment ID: I20130906000431 |
| Provider Name | Julia Brock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285688937 PECOS PAC ID: 3779566245 Enrollment ID: I20130912000123 |
| Provider Name | Juan M Palma Vargas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528072675 PECOS PAC ID: 7113980442 Enrollment ID: I20131206000251 |
| Provider Name | Karen A Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588801773 PECOS PAC ID: 9638355480 Enrollment ID: I20150428001457 |
| Provider Name | Gary L Diperna |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649567579 PECOS PAC ID: 2567696446 Enrollment ID: I20150515001007 |
| Provider Name | Carrie Maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659588515 PECOS PAC ID: 2163733478 Enrollment ID: I20150612000593 |
| Provider Name | Michael A Ferguson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013181668 PECOS PAC ID: 6305024878 Enrollment ID: I20150806011517 |
| Provider Name | Abigail Keenan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598051989 PECOS PAC ID: 5597991497 Enrollment ID: I20150819007786 |
| Provider Name | Scot C Remick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417977067 PECOS PAC ID: 4284720111 Enrollment ID: I20160324000540 |
| Provider Name | Paige Teller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578631420 PECOS PAC ID: 9537232947 Enrollment ID: I20160629001294 |
| Provider Name | Kathryn E Sharpless |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396966529 PECOS PAC ID: 7214004050 Enrollment ID: I20161004001559 |
| Provider Name | Gary M Hochheiser |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1689678112 PECOS PAC ID: 4789650060 Enrollment ID: I20161228000128 |
| Provider Name | Elizabeth Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336696285 PECOS PAC ID: 2961783683 Enrollment ID: I20170111001193 |
| Provider Name | Emily L Carter |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1790122927 PECOS PAC ID: 6002058211 Enrollment ID: I20170829001119 |
| Provider Name | Elizabeth Susan Mariah Desjardin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275829699 PECOS PAC ID: 2264668912 Enrollment ID: I20170912001525 |
| Provider Name | Mahendra Mangray |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1801074919 PECOS PAC ID: 7517153844 Enrollment ID: I20180127000103 |
| Provider Name | Michael E Zubrow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699066647 PECOS PAC ID: 1951676808 Enrollment ID: I20180613001526 |
| Provider Name | Bram J Geller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275828311 PECOS PAC ID: 2567769086 Enrollment ID: I20180723001565 |
| Provider Name | Jorge L Escobar Valle |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730529108 PECOS PAC ID: 5294063541 Enrollment ID: I20190823001750 |
| Provider Name | Avery R Osella |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104321009 PECOS PAC ID: 4981006368 Enrollment ID: I20211124002109 |
Daniel Mark Merson Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Forest Ave, Portland, ME 04103 Phone: 207-878-5042 Fax: 207-878-5043 | |
John Stanhope Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 Brighton Ave, Portland, ME 04102 Phone: 207-774-2677 Fax: 207-774-5895 | |
City Of Portland Hhs, Phd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 389 Congress St, Room 307, Portland, ME 04101 Phone: 207-874-8784 | |
Michael L. Shuman, M.d.p.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Mellen St, Portland, ME 04101 Phone: 207-774-3835 Fax: 207-774-2176 | |
Maurice C. Hothem, Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 Auburn St, Portland, ME 04103 Phone: 207-797-4148 Fax: 207-797-5730 | |
Fore River Family Medicine, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 51 Sewall St, Portland, ME 04102 Phone: 207-772-8823 Fax: 207-772-1856 |