Individual provider Active NPI

Tracy Tippie, MD

  • Emergency Medicine Physician
  • Lewiston, ME
National Provider Identifier
1124090204
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
015916 Issued in ME
Practice address
300 Main St
Lewiston, ME 04240-7007
Phone
(207) 795-0111
NPI assigned
Feb 3, 2006
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 015916 ME Primary

Addresses

Primary practice location

300 Main St
Lewiston, ME 04240-7007

Mailing address

300 Main St
Lewiston, ME 04240-7007
Phone (207) 795-0111

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
I20050601000636 ME Practitioner - Emergency Medicine 3375585227 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015916MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 1, 2019 Accepting new patients
Calais Regional Hospital CurrentSince Nov 1, 2014 Accepting new patients
Calais Community Hospital CurrentSince Nov 1, 2014 Accepting new patients
Mainehealth CurrentSince Jun 1, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Calais Community Hospital Current Accepting new patients
Mainehealth Current Accepting new patients

Locations

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

24 Hospital Ln
Calais, ME 04619
Phone (207) 454-9213

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

329 Maine St
Mere Point, ME 04011
Phone (207) 373-2250

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

Organizations & group practices 8

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1124090204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407007",
            "telephone_number": "207-795-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407007",
            "telephone_number": "207-795-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPIE",
        "first_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "015916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.