Mark Eugene Bolduc, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

011486 Issued in ME

Practice address

325 Kennedy Memorial Dr # B
Waterville, ME 04901-4517

Phone

(207) 872-7171

Fax

(207) 877-7268

NPI assigned

Jul 31, 2006

Last updated

Feb 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

89.98 of 100Reported as group

Quality

74.88

Promoting interoperability

96

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

90.63 of 100Reported as group

Quality

77.69

Promoting interoperability

95

Improvement activities

40

Cost

78.59

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment NPD
• Mainegeneral Medical Center

  dba MaineGeneral Pharmacy

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD
• Mainegeneral Medical Center

  dba MaineGeneral Speciality Care

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1083949184

  Surgery

  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1043226129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 KENNEDY MEMORIAL DR # B",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014517",
            "telephone_number": "207-872-7171",
            "fax_number": "207-877-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 KENNEDY MEMORIAL DR # B",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014517",
            "telephone_number": "207-872-7171",
            "fax_number": "207-877-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDUC",
        "first_name": "MARK",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "011486",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "ME",
            "license": "011486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "039918",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M101030",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blue Sky Counseling Inc
• Carol Boehm, CRNP
• Beth Bois
• Evan Daniel Bois, PHARM.D.
• Lydia Bolduc-Marden, N.P.
• Ashleigh Bryanna Bone, LCPC-C
• John Kent Bonney, MD
• Theresa Marie Bonsey, R.PH., M.P.H, BCPS
• Mary Anne F Booth, M.A., CCC-A
• Jonathan M Borkum, PHD

• Vascular Surgery Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Vascular Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.

Verify at the official NPI Registry.