NPIMap

Individual provider Active NPI

Kristen Alyse Scopaz, MD

  • Family Medicine Physician
  • Scarborough, ME
National Provider Identifier
1114171857
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD19333 Issued in ME
Practice address
20 Mussey Rd
Scarborough, ME 04074-9570
Phone
(207) 885-1333
Fax
(207) 885-1332
NPI assigned
Nov 7, 2008
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19333 ME Primary
Sports Medicine (Family Medicine) Physician 207QS0010X MD19333 ME

Addresses

Primary practice location

20 Mussey Rd
Scarborough, ME 04074-9570

Mailing address

20 Mussey Rd
Scarborough, ME 04074-9570
Phone (207) 885-1333

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
I20121109000505 ME Practitioner - Family PracticePractitioner - Sports Medicine 6305097825 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Whole Medicine LLCGroup PAC ID 6800206996, 2 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

20 Mussey Rd
Suite 2
Scarborough, ME 04074-9570
Phone (207) 885-1333

730 Ctr St
Suite 9
Auburn, ME 04210-6316
Phone (207) 783-3450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19333MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Sep 1, 2012 Accepting new patients
Maine Medical Partners Family Medicine CurrentSince Sep 1, 2012 Accepting new patients
Whole Medicine LLC Family Medicine CurrentSince Oct 10, 2023 Accepting new patients
Maine Medical Partners CurrentSince Jan 1, 2013 Accepting new patients
Mainehealth Family Medicine CurrentSince Oct 1, 2012 Accepting new patients
Spectrum Healthcare Partners, PA PastSince Oct 10, 2023 Accepting new patients

Locations

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

272 Congress St
Portland, ME 04101
Phone (207) 874-2466

20 Mussey Rd
Ste 2
Scarborough, ME 04074
Phone (207) 885-1333

300 Professional Dr
Ste 2C
Scarborough, ME 04074
Phone (207) 883-7926

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

96 Campus Dr
Ste 2C
Scarborough, ME 04074
Phone (207) 883-7926

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: kristen.scopaz.1@32540.direct.athenahealth.com

Organizations & group practices 6

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1114171857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MUSSEY RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749570",
            "telephone_number": "207-885-1333",
            "fax_number": "207-885-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MUSSEY RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749570",
            "telephone_number": "207-885-1333",
            "fax_number": "207-885-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOPAZ",
        "first_name": "KRISTEN",
        "middle_name": "ALYSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD19333",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD19333",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.