Individual provider Active NPI

Scott Raymond Johnson, MD

  • Surgery Physician
  • Lewiston, ME
National Provider Identifier
1104896133
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD21930 Issued in ME
Practice address
12 High St Ste 401
Lewiston, ME 04240-7690
Phone
(207) 795-5767
Fax
(207) 795-2732
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD21930 ME Primary
Transplant Surgery Physician 204F00000X 216275 MA

Addresses

Primary practice location

12 High St Ste 401
Lewiston, ME 04240-7690

Mailing address

12 High St
Lewiston, ME 04240-7676
Phone (207) 795-5767

Other practice location 1

420 Franklin St
Rumford, ME 04276-2104
Phone (207) 369-1106

Other practice location 2

110 Francis St
Lmob 7
Boston, MA 02215-5501
Phone (617) 632-9824

Other practice location 3

12 High St Ste 401
Lewiston, ME 04240-7690
Phone (207) 795-5767

Other practice location 4

25 Hospital Dr
Bridgton, ME 04009-1167
Phone (207) 647-4234

Other identifiers 3

IdentifierTypeStateIssuer
J25610OtherMABLUE CROSS
216275OtherMATUFTS HEALTH PLAN
0184144OtherMAMASSHEALTH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180116000085 ME Practitioner - General Surgery 1153398664 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Cincinnati College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45492MAMDPsychiatry Physician
MD21930MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgton Hospital CurrentSince Jan 15, 2018 Accepting new patients
Mainehealth CurrentSince Oct 11, 2022 Accepting new patients
Rumford Hospital CurrentSince Jan 15, 2018 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 9, 2025 Accepting new patients
Central Maine Medical Center CurrentSince Jan 15, 2018 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 9, 2025 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 11, 2022 Accepting new patients
Central Maine Medical Center CurrentSince Jan 15, 2018 Accepting new patients
Bridgton Hospital CurrentSince Jan 15, 2018 Accepting new patients
Rumford Hospital CurrentSince Jan 15, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

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

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

25 Hospital Dr
Bridgton, ME 04009
Phone (207) 524-3501

12 High St
Ste 401
Lewiston, ME 04240
Phone (207) 795-2494

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

12 High St
Lewiston, ME 04240
Phone (207) 795-5730

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

4 Glen Cove Dr
Ste 103
Rockport, ME 04856
Phone (207) 301-5737

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

105 Topsham Fair Mall Rd
Unit 2
Topsham, ME 04086
Phone (207) 798-6300

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 12

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104896133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407676",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST STE 401",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407690",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-2732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Rumford",
            "state": "ME",
            "postal_code": "042762104",
            "country_code": "US",
            "telephone_number": "207-369-1106",
            "fax_number": "207-369-1180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Francis St",
            "address_2": "LMOB 7",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155501",
            "country_code": "US",
            "telephone_number": "617-632-9824",
            "fax_number": "617-632-9820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 High St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042407690",
            "country_code": "US",
            "telephone_number": "207-795-5767",
            "fax_number": "207-795-2732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgton",
            "state": "ME",
            "postal_code": "040091167",
            "country_code": "US",
            "telephone_number": "207-647-4234",
            "fax_number": "207-647-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD21930",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MA",
            "license": "216275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J25610",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "216275",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "0184144",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.