DOUGLAS GARDNER ERTMAN (M.D.) – Family Medicine Physician, NPI 1043253636

DOUGLAS GARDNER ERTMAN (M.D.) is a healthcare provider. based in Portland, Maine. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 014987 (ME). The NPI Number for DOUGLAS GARDNER ERTMAN (M.D.) is 1043253636

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DOUGLAS GARDNER ERTMAN (M.D.)
NPI
1043253636
Phone
(207) 879-3000
Address
144 STATE ST
Enumeration Date
13 June 2006
Last Update Date
25 January 2012

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2074008600
Graduation Year
1989 (37 years ago)
PAC ID
4587567326
Group Practice PAC ID
6103737812
Professional Enrollment ID
I20040129000739
Address ID
ME040624821WI409XXTRLX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

886 FAMILY PRACTICE in ME

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Provider Addresses for DOUGLAS GARDNER ERTMAN (M.D.)

  • Mercy Hospital, 144, State Street, Old Port, Portland, Cumberland County, Maine, 04102, United States

    PORTLAND, ME 041013776

    Phone: (207) 879-3000

    Type: Mailing

  • Mercy Quick Care, 385, Route 1, Yarmouth, Cumberland County, Maine, 04096, United States

    YARMOUTH, ME 040966729

    Phone: (207) 535-1200

    Fax: (207) 535-1249

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-01-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040129000739IFamily PracticeMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes4949$0
View full utilization report →

Insurance plans in this area (ZIP 04101)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103737812View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMA
-ME
H O S P I T A L I S TME
-VT
-ME
Nurse PractitionerPA
-ME
-ME
Nurse PractitionerNY
Certified Registered Nurse Anesthetist (Crna)ME

Reviews

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Frequently asked questions

What unique ID ties claims to DOUGLAS GARDNER ERTMAN (M.D.)?
NPI 1043253636 is assigned to DOUGLAS GARDNER ERTMAN (M.D.) under the national enumeration system.
Is DOUGLAS GARDNER ERTMAN (M.D.) currently active in the NPI registry?
CMS-published data lists DOUGLAS GARDNER ERTMAN (M.D.) as an active registrant.
What kind of provider is DOUGLAS GARDNER ERTMAN (M.D.)?
The page reflects Family Medicine Physician for DOUGLAS GARDNER ERTMAN (M.D.). Clinical services aligned with this taxonomy classification.
Does DOUGLAS GARDNER ERTMAN (M.D.) practice in Maine?
You will see Portland, Maine on file for DOUGLAS GARDNER ERTMAN (M.D.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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