MAINEHEALTH – NPI #1164610242
Internal Medicine

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

MAINEHEALTH is a provider located in PORTLAND, ME. NPPES has assigned the NPI number 1164610242 to MAINEHEALTH on October 15, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RG0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Geriatric Medicine

The NPI profile was last updated on Apr 01, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MAINEHEALTH below.

NPI Profile for
MAINEHEALTH

NPI Number
1164610242
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAINEHEALTH
Primary location
22 BRAMHALL ST
PORTLAND, ME 04102
Phone: (207) 662-6353 Fax:
Mailing address
301 US ROUTE 1
BUILDING C
SCARBOROUGH, ME 04074-7609
Phone: (207) 396-8600 Fax: (207) 396-8632
Organization Subpart
No
Authorized Official
LUGENE INZANA
SVP FINANCE/CFO
Phone: (207) 662-3538
Updated
Certification Date
Apr 01, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MAINEHEALTH

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidME102500205
medicaidNH30216948
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RG0300X
- Internal Medicine / Geriatric Medicine (Primary)
207QG0300X
- Family Medicine / Geriatric Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.1068.1
Content Type
Affiliation
Y
Endpoint Location
2720 DUNDEE RD # 302,
NORTHBROOK, IL 77025-1669