Individual provider Active NPI

Alexis Desjardins, AGNP-C

  • Gerontology Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1295517266
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP231498 Issued in ME
Practice address
96 Campus Dr
Scarborough, ME 04074-7163
Phone
(207) 885-9905
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X CNP231498 ME Primary

Addresses

Primary practice location

96 Campus Dr
Scarborough, ME 04074-7163

Mailing address

96 Campus Dr
Scarborough, ME 04074-7163

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117002126 ME Practitioner - Nurse Practitioner 2860840550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

96 Campus Dr
Scarborough, ME 04074-7163
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039
  • Mainehealth Mid Coast Hospital Hospital, Brunswick, ME, CCN 200021
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307

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

State licenses

LicenseStateTypeSpecialty
CNP231498MEMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Nov 27, 2023 Accepting new patients
Mainehealth CurrentSince Nov 27, 2023 Accepting new patients
Mainehealth CurrentSince Nov 27, 2023 Accepting new patients
Maine Medical Partners CurrentSince Nov 27, 2023 Accepting new patients
Mainehealth Current Accepting new patients

Locations

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

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

96 Campus Dr
Scarborough, ME 04074
Phone (207) 885-9905

Interoperability endpoints

  • Direct secure messaging: adesjardins642525@direct.mmc.mainehealth.org

Organizations & group practices 5

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1295517266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "ALEXIS",
        "name_prefix": "Ms.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "CNP231498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.