NPIMap

Individual provider Active NPI

Jacob Charles Cooper, MD

  • Hospitalist Physician
  • Portland, ME
National Provider Identifier
1407433709
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD29409 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3175
Phone
(207) 662-0111
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD29409 ME
Hospitalist Physician 208M00000X MD29409 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3175

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4618

Other practice location 1

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7937

Other practice location 2

25 June St
Sanford, ME 04073-2621
Phone (207) 324-4310

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
I20250716001319 ME Practitioner - Internal Medicine 5698177228 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
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)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

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

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD29409MEMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Jun 11, 2025 Accepting new patients
Mainehealth CurrentSince Oct 25, 2025 Accepting new patients
Mainehealth CurrentSince Oct 25, 2025 Accepting new patients
Bridgton Hospital CurrentSince Jun 11, 2025 Accepting new patients
Central Maine Medical Center Current Accepting new patients
Rumford Hospital CurrentSince Jun 11, 2025 Accepting new patients
Bridgton Hospital CurrentSince Jun 11, 2025 Accepting new patients
Rumford Hospital CurrentSince Jun 11, 2025 Accepting new patients
Central Maine Medical Center CurrentSince Jun 11, 2025 Accepting new patients
Mainehealth Past Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

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

22 Bramhall St
#C
Portland, ME 04102

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

25 June St
Sanford, ME 04073
Phone (207) 324-4310

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: jcooper368099@direct.mmc.mainehealth.org

Organizations & group practices 12

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1407433709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "207-662-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7937",
            "fax_number": "207-283-7018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 June St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732621",
            "country_code": "US",
            "telephone_number": "207-324-4310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JACOB",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD29409",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD29409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.