MAINEHEALTH NPI 1639194509

NPI Information

  • NPI: 1639194509
  • Provider Name: MAINEHEALTH
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: MMP FAMILY MEDICINE
  • CLIA Number: 20D0702786
  • Address: 272 CONGRESS ST
    PORTLAND, ME
    ZIP 04101
  • Phone: (207) 874-2466

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NPI Details

MAINEHEALTH is a family medicine in Portland, ME. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MAINEHEALTH NPI is 1639194509. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mmp Family Medicine.

The provider's business location address is:

272 CONGRESS ST
PORTLAND, ME
ZIP 04101
Phone: (207) 874-2466
Fax: (207) 774-4625

The provider's authorized official is Lugene Anthony Inzana .
The authorized official title is Chief Financial Officer and has the following contact phone number (207) 662-3538.

The CLIA number assigned to this NPI record is 20D0702786 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 12/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalNo
2207QG0300XFamily MedicineGeriatric MedicineNo
3207QS0010XFamily MedicineSports MedicineNo
42084P0800XPsychiatry & NeurologyPsychiatryNo
5363A00000XPhysician AssistantNo
6363LW0102XNurse PractitionerWomen's HealthNo
7207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
130216370MEDICAIDNEW HAMPSHIRE
2102500200MEDICAIDMAINE
3102500202MEDICAIDMAINE
4102500000MEDICAIDMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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