Active NPI
Gavin M Ducker, MD
- Family Medicine Physician
- Scarborough, ME
National Provider Identifier
1013062348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD015525
- Practice address
- 300 Professional Dr Ste 2C
Scarborough, ME 04074-8897 - Phone
- (207) 883-7926
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD015525 | ME | Primary |
Addresses
Primary practice location
300 Professional Dr Ste 2C
Scarborough, ME 04074-8897
Mailing address
174 Kennedy Memorial Dr
Waterville, ME 04901-5134
Phone (207) 861-3338
Other practice location 1
80 Main Street
Unity, ME 04988-0000
Phone (207) 948-2100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116010200 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
272 Congress St
Portland, ME 04101-3637
Phone (207) 874-2466
Hospital & facility affiliations
- Mainehealth Maine Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD015525 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Maine Medical Center | Current | Accepting new patients | |
| York Hospital | Family Medicine | Current | Accepting new patients |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Family Medicine | Current | Accepting new patients |
| Central Maine Medical Center | Current | Accepting new patients |
Locations
789 Minot Ave
Auburn, ME 04210
Phone (207) 795-8475
300 Main St
Lewiston, ME 04240
Phone (207) 795-2400
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
1474 Main St
Sanford, ME 04073
Phone (207) 608-8425
300 Professional Dr
Ste 2C
Scarborough, ME 04074
Phone (207) 883-7926
15 Hospital Dr
York, ME 03909
Phone (207) 351-2478
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
- gducker704708@direct.mmc.mainehealth.org
Organizations & group practices 6
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- General Acute Care Hospital
- Lewiston, ME
- NPI 1689653487
-
- Community/Retail Pharmacy
- Lewiston, ME
- NPI 1033874458
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1013062348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 KENNEDY MEMORIAL DR",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049015134",
"telephone_number": "207-861-3338",
"fax_number": "207-861-3281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PROFESSIONAL DR STE 2C",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040748897",
"telephone_number": "207-883-7926"
}
],
"practiceLocations": [
{
"address_1": "80 MAIN STREET",
"address_purpose": "LOCATION",
"city": "UNITY",
"state": "ME",
"postal_code": "049880000",
"country_code": "US",
"telephone_number": "207-948-2100",
"fax_number": "207-948-3018",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUCKER",
"first_name": "GAVIN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "MD015525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116010200",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.