Individual provider Active NPI

Kathleen Mathews, MSN, APRN

  • Acute Care Nurse Practitioner
  • Portland, ME
National Provider Identifier
1346918455
Registry record updated Sep 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP241354 Issued in ME
Practice address
175 Fore River Pkwy
Portland, ME 04102-2779
Phone
(207) 879-3000
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2024

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 CNP241354 ME Primary

Addresses

Primary practice location

175 Fore River Pkwy
Portland, ME 04102-2779

Mailing address

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220128000016 GA Practitioner - Nurse Practitioner 9638561483 Reassigns benefits to 1 organization
I20240916001680 ME Practitioner - Nurse Practitioner 9638561483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
CNP241354MEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Oct 6, 2024 Accepting new patients
Mercy Hospital CurrentSince Oct 6, 2024 Accepting new patients
Mercy Hospital Current Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Jan 19, 2022 Accepting new patients

Locations

1834 Clairmont Rd
Ste 100
Decatur, GA 30033
Phone (404) 634-4443

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 4

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1346918455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FORE RIVER PKWY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022779",
            "telephone_number": "207-879-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FORE RIVER PKWY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022779",
            "telephone_number": "207-879-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "KATHLEEN",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP241354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.