NPIMap

Individual provider Active NPI

Sean M O'Donnell, MD

  • Internal Medicine Physician
  • Damariscotta, ME
National Provider Identifier
1285632695
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14975 Issued in ME
Practice address
35 Miles St
Damariscotta, ME 04543-4047
Phone
(207) 563-4146
Fax
(207) 563-3717
NPI assigned
Jul 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 014975 ME
Internal Medicine Physician 207R00000X MD14975 ME Primary

Addresses

Primary practice location

35 Miles St
Damariscotta, ME 04543-4047

Mailing address

35 Miles St
Damariscotta, ME 04543-4047
Phone (207) 563-4146

Other identifiers 1

IdentifierTypeStateIssuer
271000099MedicaidME

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
I20040728000896 ME Practitioner - Internal Medicine 2264402148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahneman Medical College of the Pacific, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

35 Mile St
Damariscotta, ME 04543-4047
Phone (207) 563-1234

Hospital & facility affiliations

  • Mainehealth Home Health and Hospice Hospice, Rockport, ME, CCN 201508
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD14975MEMDInternal Medicine Physician
014975MEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients

Locations

236 Townsend Ave
Boothbay Hbr, ME 04538
Phone (207) 633-1540

6 Saint Andrews Ln
Boothbay Hbr, ME 04538
Phone (207) 633-1928

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

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

3 Glen Cove Dr
#3
Rockport, ME 04856
Phone (207) 301-5400

Interoperability endpoints

  • Direct secure messaging: sodonnell19748@direct.southcoast.org
  • Direct secure messaging: sodonnell1031@direct.mmc.mainehealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Coves EdgeDamariscotta, ME, CCN 205067 Skilled nursing facility Corporate Officer
Trustee of the SNF		 Oct 1, 2024
Oct 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1285632695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MILES ST",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434047",
            "telephone_number": "207-563-4146",
            "fax_number": "207-563-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MILES ST",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434047",
            "telephone_number": "207-563-4146",
            "fax_number": "207-563-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "SEAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-09",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "014975",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD14975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271000099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Damariscotta, ME

Sources for this page

Verify at the official NPI Registry.