NPIMap

Individual provider Active NPI

Stephen Thomas Ryan, MD

  • Urology Physician
  • South Portland, ME
National Provider Identifier
1205198686
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD23077 Issued in ME
Practice address
100 Brickhill Ave
South Portland, ME 04106-1999
Phone
(207) 773-1728
Fax
(207) 773-8153
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD23077 ME Primary

Addresses

Primary practice location

100 Brickhill Ave
South Portland, ME 04106-1999

Mailing address

100 Brickhill Ave
South Portland, ME 04106-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ME2 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
I20170727001578 CA Practitioner - Urology 9234409038 Reassigns benefits to 1 organization
I20190801000107 ME Practitioner - Urology 9234409038 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Brody School of Medicine at East Carolina University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

100 Brickhill Ave
South Portland, ME 04106-1999
Phone (207) 775-1255

730 Ctr St
Auburn, ME 04210-6316
Phone (207) 783-3450

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307
  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039
  • Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD23077MEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners Current Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2017 Accepting new patients
Regents of the University of California Urology CurrentSince Jul 1, 2017 Accepting new patients
Mainehealth CurrentSince Aug 15, 2019 Accepting new patients
Mainehealth CurrentSince Aug 15, 2019 Accepting new patients
Maine Medical Partners CurrentSince Aug 15, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Urology CurrentSince Aug 15, 2019 Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

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

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

100 Brickhill Ave
South Portland, ME 04106
Phone (207) 773-1728

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

Interoperability endpoints

  • Direct secure messaging: sryan17358@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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1205198686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728",
            "fax_number": "207-773-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "MD23077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.