NPIMap

Individual provider Active NPI

Nicholas P Trochalakis, PA-C

  • Physician Assistant
  • Dover, NH
National Provider Identifier
1164901492
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1905 Issued in NH
Practice address
14 Webb PL
Dover, NH 03820-2467
Phone
(603) 742-7900
NPI assigned
Aug 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Physician Assistant 363A00000X
Physician Assistant 363A00000X 1905 NH Primary

Addresses

Primary practice location

14 Webb PL
Dover, NH 03820-2467

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221017002188 ME Practitioner - Physician Assistant 7012383045 Reassigns benefits to 2 organizations
I20221122002242 NH Practitioner - Physician Assistant 7012383045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 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

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
1905NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 4, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Mainehealth CurrentSince Mar 4, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272

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

950 Main St
Westbrook, ME 04092
Phone (207) 517-3800

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

14 Webb Pl
Dover, NH 03820
Phone (603) 742-7900

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

111 New Hampshire Ave
Portsmouth, NH 03801

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

Interoperability endpoints

  • Direct secure messaging: ntrochalakis696912@direct.mmc.mainehealth.org

Organizations & group practices 9

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1164901492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WEBB PL",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202467",
            "telephone_number": "603-742-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROCHALAKIS",
        "first_name": "NICHOLAS",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.