Individual provider Active NPI

Jason Robert Stephansky, PA

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1134858418
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
335 Brighton Ave Ste 200
Portland, ME 04102-2362
Phone
(207) 662-8600
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

335 Brighton Ave Ste 200
Portland, ME 04102-2362

Mailing address

1130 Washington St
Whitman, MA 02382-1236
Phone (781) 710-0072

Other identifiers 1

IdentifierTypeStateIssuer
PA2392OtherMEBOARD OF LICENSURE IN MEDICINE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922003508 ME Practitioner - Physician Assistant 1052796356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New England, College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

335 Brighton Ave
Portland, ME 04102-2363
Phone (207) 662-8000

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Sep 6, 2022 Accepting new patients
Mainehealth CurrentSince Sep 6, 2022 Accepting new patients
Mainehealth CurrentSince Sep 6, 2022 Accepting new patients
Maine Medical Partners CurrentSince Sep 6, 2022 Accepting new patients

Locations

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

335 Brighton Ave
Ste 200
Portland, ME 04102
Phone (207) 662-8600

Interoperability endpoints

  • Direct secure messaging: jstephansky458060@direct.mmc.mainehealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1134858418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 WASHINGTON ST",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023821236",
            "telephone_number": "781-710-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE STE 200",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022362",
            "telephone_number": "207-662-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHANSKY",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF LICENSURE IN MEDICINE",
            "identifier": "PA2392",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.