Active NPI
Mollie Claire Waller
- Physician Assistant
- Portsmouth, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1900 Lafayette Rd Ste a
Portsmouth, NH 03801-5679 - Phone
- (603) 431-1121
- NPI assigned
- Sep 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary | ||
| Surgical Physician Assistant | 363AS0400X | |||
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
1900 Lafayette Rd Ste a
Portsmouth, NH 03801-5679
Mailing address
1900 Lafayette Rd Ste a
Portsmouth, NH 03801-5679
Phone (603) 431-1121
Other practice location 1
16 Hospital Dr Ste B
York, ME 03909-1041
Phone (603) 431-1121
Other practice location 2
15 Durham Rd Ste 108
Dover, NH 03820-4791
Phone (603) 431-1121
Other names 1
- Mollie Claire Gardner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15 Durham Rd
Suite 108
Dover, NH 03820-4380
Phone (603) 431-1121
16 Hospital Dr
Suite B
York, ME 03909-1041
Phone (207) 363-3490
1900 Lafayette Rd
Suite a
Portsmouth, NH 03801-5679
Phone (603) 431-1121
Hospital & facility affiliations
- York Hospital
- Portsmouth Regional Hospital
- Wentworth-Douglass Hospital
- Huggins Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportsmedicine Atlantic Orthopaedics PA | Current | Accepting new patients |
Locations
16 Hospital Dr
Ste B
York, ME 03909
Phone (207) 351-8117
15 Durham Rd
Ste 108
Dover, NH 03820
Phone (603) 431-1121
1900 Lafayette Rd
Ste A
Portsmouth, NH 03801
Phone (603) 431-1121
Organizations & group practices 1
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 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, NH
- NPI 1518913607
-
- Critical Access Hospital
- Wolfeboro, NH
- NPI 1366476079
-
- General Acute Care Hospital
- Dover, NH
- NPI 1033118104
-
- General Acute Care Hospital
- York, ME
- NPI 1376528398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1235918368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 LAFAYETTE RD STE A",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015679",
"telephone_number": "603-431-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 LAFAYETTE RD STE A",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015679",
"telephone_number": "603-431-1121"
}
],
"practiceLocations": [
{
"address_1": "16 Hospital Dr Ste B",
"address_purpose": "LOCATION",
"city": "York",
"state": "ME",
"postal_code": "039091041",
"country_code": "US",
"telephone_number": "603-431-1121",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15 Durham Rd Ste 108",
"address_purpose": "LOCATION",
"city": "Dover",
"state": "NH",
"postal_code": "038204791",
"country_code": "US",
"telephone_number": "603-431-1121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLER",
"first_name": "MOLLIE",
"middle_name": "CLAIRE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-27",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MOLLIE",
"last_name": "GARDNER",
"middle_name": "CLAIRE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portsmouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.