MEDICARE: DR. JENNIFER BUPP MEKO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35391	TN
2	207P00000X	Emergency Medicine Physician	12405	NV
3	207P00000X	Emergency Medicine Physician	036164336	IL
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	213661	NY
5	207P00000X	Emergency Medicine Physician	MD0000035391	TN
6	207P00000X	Emergency Medicine Physician	213661	NY
7	207P00000X	Emergency Medicine Physician	MD24057	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4215248	OTHER	TN	BCBS-TN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568530178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER BUPP MEKO MD

Provider Business Mailing Address
First Line	:	9 PHEASANT HILL RD
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04107-9661
Country	:	US
Telephone Number	:	615-260-7921
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 WASHINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2737
Country	:	US
Telephone Number	:	207-791-3888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	05/29/2025

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Directions to “ DR. JENNIFER BUPP MEKO MD” Practice Location

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