NPIMap

Individual provider Active NPI

Kelsey Averill

  • Acute Care Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1326796475
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP221109 Issued in ME
Practice address
99 Campus Ave Ste 301
Lewiston, ME 04240-6045
Phone
(207) 777-5300
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X CNP221109 ME Primary

Addresses

Primary practice location

99 Campus Ave Ste 301
Lewiston, ME 04240-6045

Mailing address

20 Getchell LN
Litchfield, ME 04350-3848
Phone (207) 513-6590

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
I20220629001743 ME Practitioner - Nurse Practitioner 7416337050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
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

99 Campus Ave
Lewiston, ME 04240-6045

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP221109MEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 1, 2022 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Jun 1, 2022 Accepting new patients
Maine Medical Partners CurrentSince Jun 1, 2022 Accepting new patients
Mainehealth CurrentSince Jun 1, 2022 Accepting new patients
Mainehealth Current Accepting new patients

Locations

99 Campus Ave
Ste 301
Lewiston, ME 04240
Phone (207) 777-4320

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

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

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: kaverill107721@direct.mmc.mainehealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1326796475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GETCHELL LN",
            "city": "LITCHFIELD",
            "state": "ME",
            "postal_code": "043503848",
            "telephone_number": "207-513-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CAMPUS AVE STE 301",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406045",
            "telephone_number": "207-777-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERILL",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP221109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.