MARK J INTEGLIA M.D.
NPI 1790717312
Pediatrics - Pediatric Gastroenterology in Portland, ME
NPI Status: Active since July 06, 2006
Contact Information
887 CONGRESS ST
SUITE 410B
PORTLAND, ME
ZIP 04102
Phone: (207) 662-5522
Fax: (207) 662-5526
- Individual
- Male
- Pediatrics
- Pediatric Gastroenterology
- Accepts Insurance
- PECOS Enrolled
About MARK INTEGLIA
This page provides the complete NPI Profile along with additional information for Mark Integlia, a pediatrician established in Portland, Maine with a medical specialization in Pediatrics, focusing in pediatric gastroenterology . The healthcare provider is registered in the NPI registry with number 1790717312 assigned on July 2006. The practitioner's primary taxonomy code is 2080P0206X with license number 015427 (ME). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1790717312
- Provider Name
- MARK J INTEGLIA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 887 CONGRESS ST SUITE 410B PORTLAND, ME 04102
- Location Phone
- (207) 662-5522
- Location Fax
- (207) 662-5526
- Mailing Address
- 301 US ROUTE 1 BUILDING C SCARBOROUGH, ME 04074
- Mailing Phone
- (207) 396-8600
- Mailing Fax
- (207) 662-5526
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-06-2006
- Last Update Date
- 01-10-2011
- Code Navigator
A pediatrician like Mark Integlia is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Gastroenterology
- Taxonomy Code
- 2080P0206X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 015427
- License State
- ME
- Taxonomy Description
- A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 015427 (ME) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/7500 RxD - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 7000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- WellSense Clarity NH Bronze 6500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Bronze 7500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Bronze 7600 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Gold 2000 + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 3400 + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 6000 + $0 Rx List + 24/7 Nurse Advice - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| H29683 | MEDICARE UPIN (02) | ME | |
| 283380099 | MEDICAID (05) | ME | |
| 30201387 | MEDICAID (05) | NH | |
| MM8650 | MEDICARE PIN (08) | ME |
Medicare Participation & PECOS Enrollment Status
Mark Integlia is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 04102 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $128.83
- Minimum New Patient Price $56.28
- Maximum New Patient Price $169.96
- Average New Patient Copayment $32.2
- Minimum New Patient Copayment $14.07
- Maximum New Patient Copayment $42.49
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $99.18
- Minimum Established Patient Price $18.22
- Maximum Established Patient Price $138.92
- Average Established Patient Copayment $24.79
- Minimum Established Patient Copayment $4.55
- Maximum Established Patient Copayment $34.73
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1790717312, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
PORTLAND, ME 04102
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790717312, enumerated as an "individual" on July 06, 2006.
The provider is located at 887 CONGRESS ST SUITE 410B PORTLAND, ME 04102 and the phone number is (207) 662-5522.
Pediatrics with taxonomy code 2080P0206X and a focus in Pediatric Gastroenterology.
The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
