NPIMap

Individual provider Active NPI

Clark E Judge, MD

  • Urology Physician
  • South Portland, ME
National Provider Identifier
1295264307
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD28197 Issued in ME
Practice address
100 Brickhill Ave Ste 201
South Portland, ME 04106-1999
Phone
(207) 773-1728
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 74011 CT
Urology Physician 208800000X 125.070949 IL
Urology Physician 208800000X MD28197 ME Primary

Addresses

Primary practice location

100 Brickhill Ave Ste 201
South Portland, ME 04106-1999

Mailing address

100 Brickhill Ave Ste 201
South Portland, ME 04106-1999
Phone (207) 773-1728

Other practice location 1

5841 S Maryland Ave # Mc6038
Chicago, IL 60637-1447
Phone (773) 834-1628

Other practice location 2

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

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
I20240803000413 ME Practitioner - Urology 8325317134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Columbia University College of Physicians and Surgeons, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

100 Brickhill Ave
South Portland, ME 04106-1999

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

730 Ctr St
Auburn, ME 04210-6316
Phone (207) 783-3450

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

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
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28197MEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 9, 2024 Accepting new patients
Mainehealth CurrentSince Sep 9, 2024 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

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

100 Brickhill Ave
Ste 201
South Portland, ME 04106
Phone (207) 773-1728

Interoperability endpoints

  • Direct secure messaging: cjudge877967@direct.mmc.mainehealth.org
  • Direct secure messaging: cjudge615524@direct.ynhh.org

Organizations & group practices 6

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1295264307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE STE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE STE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # Mc6038",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-834-1628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "CLARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "74011",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125.070949",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "MD28197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.