NPIMap

Individual provider Active NPI

Ryan Christopher Jackson, MD

  • Emergency Medicine Physician
  • Portland, ME
National Provider Identifier
1184060188
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD20548 Issued in ME
Practice address
335 Brighton Ave
Portland, ME 04102-2363
Phone
(207) 662-0111
Fax
(207) 662-8133
NPI assigned
May 16, 2013
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 MD20548 ME Primary

Addresses

Primary practice location

335 Brighton Ave
Portland, ME 04102-2363

Mailing address

335 Brighton Ave
Portland, ME 04102-2363
Phone (207) 662-0111

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2381

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216002546 ME Practitioner - Emergency Medicine 4082856208 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Geisel School of Medicine at Dartmouth, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
York HospitalGroup PAC ID 6406766781, 202 clinicians
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

15 Hospital Dr
York, ME 03909-1011
Phone (207) 363-4321

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280

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

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
MD20548MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 25, 2016 Accepting new patients
Bluewater Emergency Partners of Brunswick, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Seacoast Pathology Inc Current Accepting new patients
York Hospital CurrentSince Jul 18, 2016 Accepting new patients
Mainehealth Emergency Medicine CurrentSince Jul 25, 2016 Accepting new patients
Mainehealth Current Accepting new patients
Bluewater Emergency Partners of Calais, LLC Dba: Bluewater Urgent Care Emergency Medicine Past Accepting new patients

Locations

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

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

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

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

Organizations & group practices 7

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.

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1184060188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022363",
            "telephone_number": "207-662-0111",
            "fax_number": "207-662-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022363",
            "telephone_number": "207-662-0111",
            "fax_number": "207-662-8133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "207-662-2381",
            "fax_number": "207-662-6226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "MD20548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.