Christian Andersen, MD
Individual provider Active NPI Emergency Medicine Physician · Bangor, ME
NPI 1124185103 · NPPES record last updated Feb 3, 2022
Key facts
- NPI
- 1124185103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD13655 (ME)
- Practice address
- 360 Broadway
Bangor, ME 04401-3900 - Phone
- (207) 907-3000
- Fax
- (207) 907-1921
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Virginia Commonwealth University, School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Joseph Hospital
Practice addresses (Care Compare)
360 Broadway
L
Bangor, ME 04401-3979
Phone (207) 907-1000
Hospital & facility affiliations
- St Joseph Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.58 of 100
- Quality
- 83.17
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050725000410 | ME | Practitioner - Family Practice | 3476580119 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13655 | ME | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Hospital | Current |
Accepting new patients |
Locations
360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703
360 Broadway
Bangor, ME 04401
Phone (207) 262-1703
Interoperability endpoints
- candersen1149044@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD13655 | ME | Yes |
Addresses
Primary practice location
360 Broadway
Bangor, ME 04401-3900
Mailing address
C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04273-7291
Phone (207) 777-8560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | candersen613701@direct-prd.goodhelpconnections.org |
Other providers in Bangor, ME
- Phillip B Amidon
- Amini Home Services LLC
- Susan Bailey Amundsen
- Amy Goode LCSW LLC
- Mindy Anders
- Alec Anderson
- Jordan Christine Anderson
- Mae Anderson
- Mary E Anderson
- Ronda Anderson
All providers in Bangor, ME · Emergency Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.