NPIMap

Individual provider Active NPI

Chad Wotkowicz, M.D.

  • Urology Physician
  • Brunswick, ME
National Provider Identifier
1003884578
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD19913 Issued in ME
Practice address
81 Medical Center Dr
Brunswick, ME 04011-2764
Phone
(207) 373-6690
Fax
(603) 373-6695
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14482 NH
Surgery Physician 208600000X 224790 MA
Urology Physician 208800000X 14482 NH
Urology Physician 208800000X MD19913 ME Primary

Addresses

Primary practice location

81 Medical Center Dr
Brunswick, ME 04011-2764

Mailing address

81 Medical Center Dr
Brunswick, ME 04011-2764
Phone (207) 373-6690

Other identifiers 2

IdentifierTypeStateIssuer
30209883MedicaidNH
2111021MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140515000156 ME Practitioner - Urology 0749207801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Massachusetts Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

81 Medical Ctr Dr
Suite 2350
Brunswick, ME 04011-2780
Phone (207) 373-6690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
224790MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jan 31, 2022 Accepting new patients
Concord Hospital-Laconia Pediatrics CurrentSince Dec 8, 2022 Accepting new patients
Mainehealth CurrentSince Jan 31, 2022 Accepting new patients
Mainehealth Pediatrics Past Accepting new patients
Lahey Clinic, Inc Past Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients
Jordan Physician Associates, Inc. Surgery Past Accepting new patients
Gateway Urology, P.a. Urology Past Accepting new patients

Locations

81 Medical Center Dr
Ste 2350
Brunswick, ME 04011
Phone (207) 373-6690

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

724 N Main St
Laconia, NH 03246
Phone (603) 524-5151

238 Daniel Webster Hwy
Meredith, NH 03253
Phone (603) 279-7464

Interoperability endpoints

  • Direct secure messaging: cwotkowicz444126@direct.mmc.mainehealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1003884578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112764",
            "telephone_number": "207-373-6690",
            "fax_number": "603-742-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MEDICAL CENTER DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112764",
            "telephone_number": "207-373-6690",
            "fax_number": "603-373-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTKOWICZ",
        "first_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "14482",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "224790",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "14482",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "MD19913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209883",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2111021",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.