MMC PEDIATRIC UROLOGY – NPI #1457540486
Urology

Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).

MMC PEDIATRIC UROLOGY is an urologist located in PORTLAND, ME. NPPES has assigned the NPI number 1457540486 to MMC PEDIATRIC UROLOGY on October 16, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MMC PEDIATRIC UROLOGY” is a dba name, the actual legal business name for this organization is MAINEHEALTH. The primary taxonomy selected by this provider is 2088P0231X from the Health Care Provider Taxonomy code set, which is classified as Urology, specializing in Pediatric Urology

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 UROLOGY below.

NPI Profile for
MAINEHEALTH

NPI Number
1457540486
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
Doing Business As (dba): MMC PEDIATRIC UROLOGY
Primary location
22 BRAMHALL ST
PORTLAND, ME 04102
Phone: (207) 662-2179 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
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.

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
2088P0231X
- Urology / Pediatric Urology (Primary)

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.