Thaddeus T Shattuck, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

018527 Issued in ME

Practice address

330 Sabattus St Ste a
Lewiston, ME 04240-5553

Phone

(207) 777-8959

Fax

(207) 753-3093

NPI assigned

Dec 21, 2006

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

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tshattuck1155636@direct.bsmhealth.org
• Direct secure messaging: tshattuck381707@direct.mmc.mainehealth.org

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.

• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• St. Mary'S Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584

  Psychiatry

  Medicare reassignment NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • General Acute Care Hospital
  • Rockport, ME
  • NPI 1578043378
  NPD
• St. Mary'S Regional Medical Center

  • Skilled Nursing Facility
  • Lewiston, ME
  • NPI 1952306524
  NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1285798447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 LANCASTER ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012406",
            "telephone_number": "207-874-1030",
            "fax_number": "207-874-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SABATTUS ST STE A",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405553",
            "telephone_number": "207-777-8959",
            "fax_number": "207-753-3093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Lancaster St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "04101",
            "country_code": "US",
            "telephone_number": "207-874-1030",
            "fax_number": "207-874-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHATTUCK",
        "first_name": "THADDEUS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "ME",
            "license": "MD18527",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "018527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ira M. Shapiro, MD
• Neil Michael Shapiro, BC-HIS
• Robert Sharkey Jr., EMT-P
• Sharon Bell & Associates Counseling Inc
• Eric Hunter Sharp, DO
• Shaws Supermarkets Inc
• George R Sheckart, PHD
• Rosemarie G Sheline, DDS
• Karen Shepard
• Cheryl A Sherman, PA-C

• Psychiatry Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.