NPIMap

Individual provider Active NPI

Elizabeth S.M. Desjardin, MD

  • Surgery Physician
  • Scarborough, ME
National Provider Identifier
1275829699
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD21127 Issued in ME
Practice address
100 Campus Dr Unit 121
Scarborough, ME 04074-7172
Phone
(207) 396-7760
Fax
(207) 396-8500
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 036140306 IL
Surgery Physician 208600000X MD21127 ME Primary

Addresses

Primary practice location

100 Campus Dr Unit 121
Scarborough, ME 04074-7172

Mailing address

190 Riverside St Unit 6B
Portland, ME 04103-1073

Other names 1

  • Elizabeth SM Hielscher Former name

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
I20170912001525 ME Practitioner - General Surgery 2264668912 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

100 Campus Dr
Suite 110
Scarborough, ME 04074-7172
Phone (207) 396-7678

887 Congress St
Suite 200
Portland, ME 04102-3166
Phone (207) 771-5549

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063
  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021

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
Mastectomy31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21127MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners Surgery CurrentSince Sep 4, 2017 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Surgery Current Accepting new patients
Mainehealth CurrentSince Sep 4, 2017 Accepting new patients
Mainehealth CurrentSince Sep 4, 2017 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Sep 4, 2017 Accepting new patients
Mainehealth Past Accepting new patients

Locations

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

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

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

100 Campus Dr
Unit 110
Scarborough, ME 04074
Phone (207) 396-7678

100 Campus Dr
Unit 121A
Scarborough, ME 04074

100 Campus Dr
Unit 121
Scarborough, ME 04074
Phone (207) 396-7760

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

Interoperability endpoints

  • Direct secure messaging: edesjardin55263@direct.mmc.mainehealth.org

Organizations & group practices 8

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 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1275829699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST UNIT 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS DR UNIT 121",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747172",
            "telephone_number": "207-396-7760",
            "fax_number": "207-396-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDIN",
        "first_name": "ELIZABETH",
        "middle_name": "S.M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "IL",
            "license": "036140306",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD21127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HIELSCHER",
            "middle_name": "SM",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.