MR. SIMBARASHE MATOI MB BCH BAO
NPI 1053056507
Student in an Organized Health Care Education/Training Program in Portland, ME

Active since April 29, 2022PECOS Enrolled
22 BRAMHALL STREET, PORTLAND, ME 04102(207) 662-0111 Get Directions Write a Review

NPPES record last updated: February 15, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 15, 2023, Apr 29, 2022 (2 updates tracked since 2022).

About Mr. Simbarashe Matoi Mb Bch Bao NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SIMBARASHE MATOI MB BCH BAO (NPI 1053056507) is an individual student in an organized health care education/training program in Portland, Maine, licensed in Maine (EC221082) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1053056507
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. SIMBARASHE MATOICredential: MB BCH BAO
Location Address22 BRAMHALL STREETPortland, ME 04102
Mailing Address58 Thirlmere AvenueSouth Portland, ME 04106 · (207) 245-5304
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateApril 29, 2022
Last NPPES UpdateFebruary 15, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2023
NPI 1053056507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
License Licensed in ME · EC221082
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

22 BRAMHALL STREET, Portland, ME 04102

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mr. Simbarashe Matoi Mb Bch Bao is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4587011770
PECOS Enrollment IDI20260612001003
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pathology (Anatomic Pathology & Clinical Pathology)
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Practitioner (Psychiatric/Mental Health)
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Practitioner (Psychiatric/Mental Health)
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Practitioner (Family)
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Anesthetist, Certified Registered
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Anesthetist, Certified Registered
22 BRAMHALL STREET
PORTLAND, ME 04102
Nurse Practitioner (Adult Health)
22 BRAMHALL STREET
PORTLAND, ME 04102
Preventive Medicine (Occupational Medicine)
22 BRAMHALL STREET
PORTLAND, ME 04102

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053056507, enumerated as an "individual" on April 29, 2022.

The provider is located at 22 BRAMHALL STREET PORTLAND, ME 04102 and the phone number is (207) 662-0111.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.