NPIMap

Individual provider Active NPI

Tyler Atkinson, PA-C

  • Physician Assistant
  • Saco, ME
National Provider Identifier
1376273243
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2395 Issued in ME
Practice address
13 Industrial Park Rd
Saco, ME 04072-1804
Phone
(207) 283-8800
NPI assigned
Jun 14, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PENDING ME
Physician Assistant 363A00000X PA2395 ME Primary

Addresses

Primary practice location

13 Industrial Park Rd
Saco, ME 04072-1804

Mailing address

87 Sherwood St Apt 2
Portland, ME 04103-5323
Phone (401) 649-0753

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
I20221017001981 ME Practitioner - Physician Assistant 2961878988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGMEMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 15, 2022 Accepting new patients
Mercy Hospital CurrentSince Nov 9, 2025 Accepting new patients
Mercy Hospital CurrentSince Nov 9, 2025 Accepting new patients
Mainehealth CurrentSince Aug 15, 2022 Accepting new patients

Locations

155 Fore River Pkwy
Ste 110
Portland, ME 04102
Phone (207) 879-3190

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

13 Industrial Park Rd
Saco, ME 04072
Phone (207) 283-8800

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

Interoperability endpoints

  • Direct secure messaging: tatkinson552482@direct.mmc.mainehealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1376273243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 SHERWOOD ST APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035323",
            "telephone_number": "401-649-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 INDUSTRIAL PARK RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721804",
            "telephone_number": "207-283-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.