Active NPI
Christina Mae Clark, PA
- Physician Assistant
- Sanford, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAN374
- Practice address
- 25A June Street
Sanford, ME 04073 - Phone
- (207) 324-1488
- NPI assigned
- Aug 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAN374 | ME | Primary |
| Surgical Physician Assistant | 363AS0400X | PAN374 | ME |
Addresses
Primary practice location
25A June Street
Sanford, ME 04073
Mailing address
57 James St
Wells, ME 04090-6151
Phone (207) 651-8072
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
25 A June St
Sanford, ME 04073-2642
46 Barra Rd
Suite 201202
Biddeford, ME 04005-9459
Phone (207) 282-3349
Hospital & facility affiliations
- Mainehealth Maine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAN374 | ME | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| The Medical Group Department of Goodall Hospital | Past | Accepting new patients |
Locations
46 Barra Rd
Biddeford, ME 04005
Phone (207) 282-3349
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
25A June St
Sanford, ME 04073
Phone (207) 324-8311
25A June St
Ste 15
Sanford, ME 04073
Phone (207) 324-1488
Interoperability endpoints
- cclark268929@direct.mmc.mainehealth.org
Organizations & group practices 4
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
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Internal Medicine Physician
- Cape Elizabeth, ME
- NPI 1619281698
-
- Family Medicine Physician
- Kennebunk, ME
- NPI 1356356869
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": "1567036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1013565498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 JAMES ST",
"city": "WELLS",
"state": "ME",
"postal_code": "040906151",
"telephone_number": "207-651-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25A JUNE STREET",
"city": "SANFORD",
"state": "ME",
"postal_code": "04073",
"telephone_number": "207-324-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHRISTINA",
"middle_name": "MAE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-29",
"last_updated": "2024-05-08",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "PAN374",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "ME",
"license": "PAN374",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.