Individual provider Active NPI

John Stephens, PA

  • Physician Assistant
  • Hampden, ME
National Provider Identifier
1104834837
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA333 Issued in ME
Practice address
7 Main Rd N
Hampden, ME 04444-1334
Phone
(207) 862-9400
Fax
(207) 862-9411
NPI assigned
Aug 5, 2006
Last updated
Feb 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA237 ME
Physician Assistant 363A00000X PA333 ME Primary

Addresses

Primary practice location

7 Main Rd N
Hampden, ME 04444-1334

Mailing address

43 Whiting Hill Rd
Suite 300
Brewer, ME 04412-1005
Phone (207) 973-5035

Other identifiers 1

IdentifierTypeStateIssuer
303790099MedicaidME

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000679 ME Practitioner - Physician Assistant 9830213354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Nov 27, 2011 Accepting new patients
Sunbury Primary Care, P.a. Physician Assistant Past Accepting new patients
Norumbega Medical Specialists, LTD Past Accepting new patients

Locations

133 Corporate Dr
#3A
Bangor, ME 04401
Phone (207) 992-0026

489 State St
Bangor, ME 04401
Phone (207) 973-8837

7 Main Rd N
Hampden, ME 04444
Phone (207) 862-4900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1104834837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "address_2": "SUITE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MAIN RD N",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441334",
            "telephone_number": "207-862-9400",
            "fax_number": "207-862-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA237",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303790099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampden, ME

Sources for this page

Verify at the official NPI Registry.