Mark A Kandutsch, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MD10687 Issued in ME

Practice address

322 Main St
Bar Harbor, ME 04609-1648

Phone

(207) 288-5081

Fax

(207) 288-8449

NPI assigned

Jan 25, 2006

Last updated

Jun 23, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Vermont College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Desert Island HospitalGroup PAC ID 0941250963, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Desert Island Hospital Hospital, Bar Harbor, ME, CCN 201304
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050

Merit-based Incentive Payment System (MIPS)

Final score

96.58 of 100Reported as apm

Quality

83.17

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

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.

• Mount Desert Island Hospital

  • Critical Access Hospital
  • Bar Harbor, ME
  • NPI 1790764512
  Medicare reassignment Care Compare group NPD
• Mount Desert Island Hospital

  dba Community Dental Center

  • Dental Clinic/Center
  • Southwest Harbor, ME
  • NPI 1235553413
  NPD

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

• Maine Coast Regional Health Facilities

  dba Northern Light Maine Coast Hospital

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• Mount Desert Island Hospital

  dba Community Dental Center

  • Dental Clinic/Center
  • Southwest Harbor, ME
  • NPI 1235553413

  Hospital

  Care Compare affiliation
• Mount Desert Island Hospital

  • Critical Access Hospital
  • Bar Harbor, ME
  • NPI 1790764512
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1194795799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WAYMAN LN",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091625",
            "telephone_number": "207-288-5081",
            "fax_number": "207-288-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091648",
            "telephone_number": "207-288-5081",
            "fax_number": "207-288-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDUTSCH",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD10687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE LICENSE",
            "identifier": "MD10687",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101990099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Dorothy Holley, LMSW-CC
• Caroline Frances Howell, PA-C
• Brianna Howlett, OTR
• Ormanda Dorothea Johnson, MD
• Cecily P Judd, LCSW
• Alexandra Nicole Kane, PA-C
• Michelle Renee Kaplan, RPA-C
• Donna Mae Karlson, LCSW ACSW
• Diane E Kay-Daigle, LCSW
• Gerald R Keenan, PA-C

• Sports Medicine (Family Medicine) Physician in Bar Harbor, ME
• Providers in Bar Harbor, ME by specialty
• Sports Medicine (Family Medicine) Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.