COURTNEY IRENE MACCALLUM AGACNP
NPI 1629966759
Nurse Practitioner - Acute Care in Portland, ME

Q: What is Courtney Maccallum's NPI number?

The NPI number for Courtney Maccallum is 1629966759. It was assigned to this individual provider in the NPPES registry on June 26, 2025.

Q: What is Courtney Maccallum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Active since June 26, 2025PECOS EnrolledAccepts Medicare Assignment

887 CONGRESS ST STE 400, PORTLAND, ME 04102(207) 774-6368(207) 774-9388 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 5, 2025, Jun 26, 2025 (2 updates tracked since 2025).

On this page

About Courtney Irene Maccallum Agacnp NPPES

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

COURTNEY IRENE MACCALLUM AGACNP (NPI 1629966759) is an individual acute care provider in Portland, Maine, licensed in Maine (CNP251297) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1629966759

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameCOURTNEY IRENE MACCALLUMCredential: AGACNP

Location Address887 CONGRESS ST STE 400Portland, ME 04102-3163

Mailing Address887 Congress St Ste 400Portland, ME 04102-3163 · (207) 774-6368 · Fax (207) 774-9388

Phone(207) 774-6368

Fax(207) 774-9388

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJune 26, 2025

Last NPPES UpdateJune 8, 20262 updates tracked since enumeration

NPPES CertifiedJune 8, 2026

✔ NPI 1629966759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in ME · CNP251297

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License CNP251297 (ME)

887 CONGRESS ST STE 400, Portland, ME 04102

Open in Google Maps ↗

Secondary Practice Location 1

Location 122 Bramhall StPortland, ME 04102-3134 · Phone (207) 662-0111

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

Courtney Irene Maccallum Agacnp 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 ID7618479593

PECOS Enrollment IDI20250909001257

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.

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 04102 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.

Leave this field empty

Other Providers at the Same Location NPPES 16

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

ANNA MARIE BONIAKOWSKI MD

Surgery (Vascular Surgery)