Individual provider Active NPI

John Noonan Jr., PA-C

  • Surgical Physician Assistant
  • Portland, ME
National Provider Identifier
1164806527
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1545 Issued in ME
Practice address
33 Sewall St
Portland, ME 04102-2603
Phone
(207) 828-2100
NPI assigned
Jul 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA1545 ME Primary

Addresses

Primary practice location

33 Sewall St
Portland, ME 04102-2603

Mailing address

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2100

Other practice location 1

818 Congress St
Portland, ME 04102-3112
Phone (207) 773-8161

Other practice location 2

22 Bramhall St
Portland, ME 04102-3175
Phone (207) 662-0111

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918000282 ME Practitioner - Physician Assistant 4587971833 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3057

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2101

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Maine CurrentSince Jun 29, 2019 Accepting new patients
Mainehealth CurrentSince Nov 27, 2017 Accepting new patients
Central Maine Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Central Maine Medical Center CurrentSince Jan 1, 2021 Accepting new patients
Maine Medical Partners Surgical CurrentSince Nov 27, 2017 Accepting new patients
Orthopaedic Associates of Maine PA CurrentSince Feb 1, 2025 Accepting new patients
Orthopaedic Associates of Maine PA CurrentSince Feb 1, 2025 Accepting new patients
Mainehealth CurrentSince Nov 27, 2017 Accepting new patients
Maine Medical Partners CurrentSince Nov 27, 2017 Accepting new patients

Locations

109 Capitol St
#11
Augusta, ME 04330

656 State St
Bangor, ME 04401
Phone (207) 941-4000

108 Centre St
Bath, ME 04530
Phone (207) 386-1800

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

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

193 Main St
Norway, ME 04268
Phone (207) 743-2544

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

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

818 Congress St
Portland, ME 04102
Phone (207) 773-8161

33 Sewall St
Portland, ME 04102
Phone (207) 772-0076

1 Wellness Way
Ste A
Topsham, ME 04086
Phone (207) 386-1808

4 Commons Ave
Ste A
Windham, ME 04062
Phone (207) 893-1738

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: john.noonan@direct.spectrumhcp.nextgenshare.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1164806527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Congress St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023112",
            "country_code": "US",
            "telephone_number": "207-773-8161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023175",
            "country_code": "US",
            "telephone_number": "207-662-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA1545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.