NPIMap

Individual provider Active NPI

Benjamin Potter, MD

  • Gastroenterology Physician
  • Portland, ME
National Provider Identifier
1285689505
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
013831 Issued in ME
Practice address
161 Marginal Way
Portland, ME 04101-2438
Phone
(207) 773-7964
Fax
(207) 773-9073
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 013831 ME Primary

Addresses

Primary practice location

161 Marginal Way
Portland, ME 04101-2438

Mailing address

161 Marginal Way Ste 300
Portland, ME 04101-2438
Phone (207) 773-7964

Other identifiers 1

IdentifierTypeStateIssuer
242360099MedicaidME

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
I20050613000625 ME Practitioner - Gastroenterology 7719964584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Geisel School of Medicine at Dartmouth, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Gastroenterology Associates PAGroup PAC ID 5193702967, 22 clinicians

Practice addresses (Care Compare)

161 Marginal Way
Portland, ME 04101-2438
Phone 2077737964232

Hospital & facility affiliations

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
Colonoscopy90
Upper gastrointestinal (GI) endoscopy for acid reflux99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013831MEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Gastroenterology Associates P.a. Gastroenterology CurrentSince May 19, 1997 Accepting new patients
Portland Endoscopy Center Past Accepting new patients

Locations

1200 Congress St
Ste 300
Portland, ME 04102
Phone (207) 773-7964

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

161 Marginal Way
Ste 300
Portland, ME 04101

Organizations & group practices 2

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1285689505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY STE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012438",
            "telephone_number": "207-773-7964",
            "fax_number": "207-773-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "013831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242360099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.