EDWARD TUMAVICUS M.D.
NPI 1316973969
Family Medicine in Portland, ME

Active since June 24, 2006PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
272 CONGRESS ST, PORTLAND, ME 04101(207) 874-2466 Get Directions Write a Review

NPPES record last updated: July 27, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edward Tumavicus M.d. NPPES

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

EDWARD TUMAVICUS M.D. (NPI 1316973969) is an individual family medicine provider in Portland, Maine, licensed in Maine (016829) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and is a graduate of University Of Massachusetts Medical School (2001).

NPPES Registry Identity

NPI1316973969
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEDWARD TUMAVICUSCredential: M.D.
Location Address272 CONGRESS STPortland, ME 04101-3637
Mailing Address301c Us Route 1Scarborough, ME 04074-9701 · (207) 396-8600 · Fax (207) 396-8632
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2001
Enumeration DateJune 24, 2006
Last NPPES UpdateJuly 27, 2015
NPI 1316973969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in ME · 016829
Definition

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.

272 CONGRESS ST, Portland, ME 04101

Other Identifiers 9

Medicaid431938799ME
Medicare PINP00259212ME
Medicare PINME161102ME
Medicaid30207091NH
Medicare UPINI44434ME
Medicare PINME161103ME
Medicare PINP00786888ME
Medicare PINME1611ME
Medicare PINME161101ME

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Edward Tumavicus M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698791325
PECOS Enrollment IDI20051021000123
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
61 services30 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
45 services34 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
29 services28 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
21 services21 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.13
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$81.68 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$29.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Family Medicine
272 CONGRESS ST
PORTLAND, ME 04101
Family Medicine
272 CONGRESS ST
PORTLAND, ME 04101
Nurse Practitioner (Family)
272 CONGRESS ST
PORTLAND, ME 04101
Hospitalist
272 CONGRESS ST
PORTLAND, ME 04101
Social Worker (Clinical)
272 CONGRESS ST
PORTLAND, ME 04101
Family Medicine
272 CONGRESS ST
PORTLAND, ME 04101
Family Medicine
272 CONGRESS ST
PORTLAND, ME 04101
Nurse Practitioner (Family)
272 CONGRESS ST
PORTLAND, ME 04101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Tumavicus's NPI number?

The NPI number for Edward Tumavicus is 1316973969. It was assigned to this individual provider in the NPPES registry on June 24, 2006.

Where is Edward Tumavicus located?

Edward Tumavicus practices at 272 Congress St, Portland, ME 04101. The listed phone number is (207) 874-2466.

What is Edward Tumavicus's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Edward Tumavicus enrolled in Medicare?

Yes. Edward Tumavicus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edward Tumavicus accept?

Health plans from Harvard Pilgrim Health Care list Edward Tumavicus as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edward Tumavicus affiliated with any hospitals?

According to CMS data, Edward Tumavicus is affiliated with Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Edward Tumavicus was last updated on July 27, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.