Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Patrick Leidholm, CNP

Individual provider Nurse Practitioner · NPI 1922765197

Jacob Patrick Leidholm, CNP is a Nurse Practitioner in Portland, Maine. Qualified in 2021, 5 years ago. Practices with Mainegeneral Medical Center, a 556-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Massachusetts and Maine.

Years since qualifying
5
Licensed in
MA, ME
In the registry since
2021
Specialties on file
3
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

22 Bramhall St
Portland, ME 04102-3134
Phone: (207) 662-4618
Fax: (207) 662-6254
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 55 Lake Ave N, Worcester, MA 01655-0002 — (508) 334-3452
  • 1 Medical Center Dr, Biddeford, ME 04005-9422 — (207) 283-7937
  • 25 June St, Sanford, ME 04073-2621 — (207) 324-4310

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence CNP231268 (ME)
Nurse Practitioner Taxonomy 363L00000X · Licence RN2361554 (MA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence RN2361554 (MA)

Record details

NPI number1922765197
Entity typeIndividual (Type 1)
GenderMale
Credentials CNP
Sole proprietorNo
NPI enumeratedNovember 23, 2021
Last updated in NPPESFebruary 24, 2026
Certification dateFebruary 24, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mainegeneral Medical Center — 556 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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