Individual provider Active NPI

Kathryn G Wadland, MD

  • Obstetrics & Gynecology Physician
  • Portland, ME
National Provider Identifier
1104994805
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
017376 Issued in ME
Practice address
195 Fore River Pkwy
Suite 440
Portland, ME 04102-2780
Phone
(207) 553-6920
Fax
(207) 553-6940
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 017376 ME Primary

Addresses

Primary practice location

195 Fore River Pkwy
Suite 440
Portland, ME 04102-2780

Mailing address

195 Fore River Pkwy
Suite 440
Portland, ME 04102-2780
Phone (207) 553-6920

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
I20070913000709 ME Practitioner - Obstetrics/Gynecology 1658465224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Human Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

195 Fore River Pkwy
Portland, ME 04102-2785

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017376MEMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Aug 29, 2010 Accepting new patients
Mercy Hospital CurrentSince Aug 29, 2010 Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

195 Fore River Pkwy
Ste 440
Portland, ME 04102
Phone (207) 553-6920

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

195 Fore River Pkwy
Ste 310
Portland, ME 04102
Phone (207) 523-5901

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1104994805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY",
            "address_2": "SUITE 440",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022780",
            "telephone_number": "207-553-6920",
            "fax_number": "207-553-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY",
            "address_2": "SUITE 440",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022780",
            "telephone_number": "207-553-6920",
            "fax_number": "207-553-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLAND",
        "first_name": "KATHRYN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ME",
            "license": "017376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.