Individual provider Active NPI

Melissa L. Tsomides, PA-C

  • Surgical Physician Assistant
  • Portland, ME
National Provider Identifier
1356440085
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-191 Issued in ME
Practice address
195 Fore River Parkway
Suite 420
Portland, ME 04102
Phone
(207) 878-3177
Fax
(207) 878-2156
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA001062 ME
Surgical Physician Assistant 363AS0400X PA-191 ME Primary

Addresses

Primary practice location

195 Fore River Parkway
Suite 420
Portland, ME 04102

Mailing address

195 Fore River Parkway
Suite 420
Portland, ME 04102
Phone (207) 878-3177

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
I20040901001317 ME Practitioner - Physician Assistant 4486629300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
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

195 Fore River Pkwy
Suite 210
Portland, ME 04102-2783
Phone (207) 553-6500

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

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-191MEMDMedical Physician Assistant
PA001062MEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Nov 30, 2011 Accepting new patients
Mercy Hospital CurrentSince Nov 30, 2011 Accepting new patients

Locations

931 Union St
Fl 3
Bangor, ME 04401

195 Fore River Pkwy
Ste 420
Portland, ME 04102
Phone (207) 553-6500

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

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1356440085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PARKWAY",
            "address_2": "SUITE 420",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-878-3177",
            "fax_number": "207-878-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PARKWAY",
            "address_2": "SUITE 420",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-878-3177",
            "fax_number": "207-878-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSOMIDES",
        "first_name": "MELISSA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA001062",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA-191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.