Louis Sepulveda

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2389 Issued in ME

Practice address

33 Sewall St
Portland, ME 04102-2603

Phone

(207) 828-2100

NPI assigned

Jul 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: lsepulveda104847@direct-chsli.net

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.

• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment Care Compare group
• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  Medicare reassignment
• Port Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Port Jefferson, NY
  • NPI 1912988395
  Medicare reassignment
• Siena Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Smithtown, NY
  • NPI 1356507099
  Medicare reassignment
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• CHS Physician Partners, PC

  • Orthopaedic Surgery Physician
  • Garden City, NY
  • NPI 1235470535
  NPD

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

• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1225646474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7861",
            "fax_number": "207-482-7898"
        },
        {
            "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": "9501 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441064711",
            "country_code": "US",
            "telephone_number": "216-368-0575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225646474",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phonsavahn Senesombath
• Seniors Greatness Living LLC
• Mary L Senore, P.T.
• Peter Steven Sentner, LCSW
• Debra K Sepulveda, M.D.
• Serenity House, Inc.
• Elizabeth G Serrage, M.D.
• Raymond Serrano, M.D.
• Services Aid Home Care LLC
• Seventy Five State Street

• Physician Assistant in Portland, ME
• Providers in Portland, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.