NPIMap

Individual provider Active NPI

Jennifer Woodbury Bragg, M.D.

  • Dermatology Physician
  • Portland, ME
National Provider Identifier
1093921025
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
017459 Issued in ME
Practice address
50 Sewall Street
Portland, ME 04102
Phone
(207) 775-3526
NPI assigned
May 15, 2007
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 017459 ME Primary

Addresses

Primary practice location

50 Sewall Street
Portland, ME 04102

Mailing address

50 Sewall Street
Portland, ME 04102
Phone (207) 775-3526

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
I20070823000258 ME Practitioner - Dermatology 6103918099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Columbia University College of Physicians and Surgeons, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates, LLCGroup PAC ID 4587698279, 21 clinicians

Practice addresses (Care Compare)

50 Sewall St
Portland, ME 04102-2691
Phone 2077753526212

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
Removal of skin lesions882
Removal or shaving of skin growth14
Skin biopsy190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017459MEMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, LLC Dermatology CurrentSince Sep 4, 2007 Accepting new patients

Locations

57 Barra Rd
Biddeford, ME 04005
Phone (207) 282-1305

2 Admiral Fitch Ave
Ste B
Brunswick, ME 04011

50 Sewall St
Portland, ME 04102
Phone (207) 775-3526

Interoperability endpoints

  • Direct secure messaging: jennifer.bragg@dermassoc.eclinicaldirectplus.com

Organizations & group practices 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1093921025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SEWALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-775-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 SEWALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-775-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "JENNIFER",
        "middle_name": "WOODBURY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ME",
            "license": "017459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.