MMC PEDIATRIC INTENSIVE CARE UNIT – NPI #1265536817
Pediatrics

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Health Care Provider Taxonomy Code for Pediatrics

MMC PEDIATRIC INTENSIVE CARE UNIT is a provider located in PORTLAND, ME. NPPES has assigned the NPI number 1265536817 to MMC PEDIATRIC INTENSIVE CARE UNIT on September 12, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MMC PEDIATRIC INTENSIVE CARE UNIT” is a dba name, the actual legal business name for this organization is MAINEHEALTH. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2080P0203X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Pediatric Critical Care Medicine

The NPI profile was previously updated about 6 years ago on May 11, 2020. 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 MMC PEDIATRIC INTENSIVE CARE UNIT below.

NPI Profile for
MAINEHEALTH

NPI Number
1265536817
Enumeration Date

(about 20 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
Doing Business As (dba): MMC PEDIATRIC INTENSIVE CARE UNIT
Primary location
22 BRAMHALL ST
PORTLAND, ME 04102
Phone: (207) 662-2179 Fax: (207) 662-6326
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
ASSOCIATE CFO
Phone: (207) 662-3538
Updated
Certification Date
May 11, 2020

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 MMC PEDIATRIC INTENSIVE CARE UNIT

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
MEDICAIDME102500000
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
2080P0203X
- Pediatrics / Pediatric Critical Care Medicine (Primary)
208000000X
- Pediatrics

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.