NPIMap

Individual provider Active NPI

Noelle Christine Cooper, AGNP-C

  • Nurse Practitioner
  • South Portland, ME
National Provider Identifier
1033633714
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP171115 Issued in ME
Practice address
265 Western Ave
South Portland, ME 04106-2458
Phone
(207) 661-0200
NPI assigned
Aug 3, 2017
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2333460 MA
Nurse Practitioner 363L00000X CNP171115 ME Primary

Addresses

Primary practice location

265 Western Ave
South Portland, ME 04106-2458

Mailing address

265 Western Ave
South Portland, ME 04106-2458
Phone (207) 661-0200

Other practice location 1

55 Fruit St
Boston, MA 02114-2696
Phone (623) 680-7661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171013001835 ME Practitioner - Nurse Practitioner 9335414572 Reassigns benefits to 3 organizations
I20230830002199 MA Practitioner - Nurse Practitioner 9335414572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

265 Western Ave
Suite 2
South Portland, ME 04106-2458
Phone (207) 396-7606

27 Industrial Ave
Suite 101
Sanford, ME 04073-5846
Phone (207) 459-1666

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

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
65.04
Promoting interoperability
100
Improvement activities
40
Cost
69.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2333460MAMDNurse Practitioner
CNP171115MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 20, 2017 Accepting new patients
Maine Medical Partners Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Maine Medical Partners CurrentSince Feb 6, 2023 Accepting new patients
Mainegeneral Medical Center CurrentSince Nov 16, 2020 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 1, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Mainegeneral Medical Center CurrentSince Nov 16, 2020 Accepting new patients
Mainehealth CurrentSince Aug 20, 2017 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

55 Fruit St
Boston, MA 02114

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

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

22 Bramhall St
Rm 4670
Portland, ME 04102
Phone (207) 662-3500

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

265 Western Ave
South Portland, ME 04106
Phone (207) 661-0200

149 North St
Waterville, ME 04901
Phone (207) 622-1959

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: cooper.noelle.mgh@direct.partners.masshiway.net
  • Direct secure messaging: ncooper107729@direct.mmc.mainehealth.org

Organizations & group practices 11

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

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1033633714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 WESTERN AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062458",
            "telephone_number": "207-661-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 WESTERN AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062458",
            "telephone_number": "207-661-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "623-680-7661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "NOELLE",
        "middle_name": "CHRISTINE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2333460",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP171115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.