Individual provider Active NPI

Michael David Kipp, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Augusta, ME
National Provider Identifier
1104122936
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD1086 Issued in ME
Practice address
3 Saint Catherine St
Augusta, ME 04330-5732
Phone
(207) 620-7273
Fax
(207) 620-7275
NPI assigned
Jan 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD1086 ME
Foot & Ankle Surgery Podiatrist 213ES0103X POD1086 ME Primary

Addresses

Primary practice location

3 Saint Catherine St
Augusta, ME 04330-5732

Mailing address

PO Box 1673
Voorhees, NJ 08043-7673
Phone (207) 620-7273

Other practice location 1

15 Enterprise Dr
Augusta, ME 04330-7997
Phone (207) 621-8700

Other practice location 2

81 Medical Center Dr
Suite 2100
Brunswick, ME 04011-2764
Phone (207) 725-4008

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000098 ME Practitioner - Podiatry 5597908699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

107 1St Park Dr
Oakland, ME 04963-5367
Phone (207) 453-3000

149 N St
Waterville, ME 04901
Phone (207) 872-1000

15 Enterprise Dr
Mainegeneral Express Care
Augusta, ME 04330-7997
Phone (207) 621-8880

35 Medical Ctr Pkwy
Augusta, ME 04330-8160
Phone (207) 621-1000

Hospital & facility affiliations

  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue134
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Mainegeneral Medical Center Current Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Foot and Ankle Associates of Maine, P.a. Podiatrist CurrentSince Jun 25, 2013 Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

310 Bath Rd
Brunswick, ME 04011
Phone (207) 373-6175

81 Medical Center Dr
Ste 2100
Brunswick, ME 04011
Phone (207) 373-6125

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

Interoperability endpoints

  • Direct secure messaging: michaelkipp@mgh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1104122936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1673",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080437673",
            "telephone_number": "207-620-7273",
            "fax_number": "207-620-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT CATHERINE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305732",
            "telephone_number": "207-620-7273",
            "fax_number": "207-620-7275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043307997",
            "country_code": "US",
            "telephone_number": "207-621-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81 Medical Center Dr",
            "address_2": "Suite 2100",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112764",
            "country_code": "US",
            "telephone_number": "207-725-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIPP",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-26",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD1086",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ME",
            "license": "POD1086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.