Individual provider Active NPI

Michael David Pleacher, MD

  • Pediatrics Physician
  • Brunswick, ME
National Provider Identifier
1417065558
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD16483 Issued in ME
Practice address
47 Watson Dr
Brunswick, ME 04011
Phone
(207) 274-0285
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X MD16483 ME
Pediatrics Physician 208000000X MD16483 ME Primary

Addresses

Primary practice location

47 Watson Dr
Brunswick, ME 04011

Mailing address

47 Watson Dr
Brunswick, ME 04011

Other practice location 1

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 773-0040

Other identifiers 1

IdentifierTypeStateIssuer
942854058645MedicaidUT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000655 ME Practitioner - Sports MedicinePractitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 2769412147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Pediatric Medicine
Education
Virginia Commonwealth University, School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

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

430 Bath Rd
Suite 102
Brunswick, ME 04011-2656
Phone (207) 442-0350

730 Ctr St
Auburn, ME 04210-6316
Phone (207) 783-3450

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jan 3, 2022 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Aug 23, 2021 Accepting new patients
Mainehealth Pediatrics CurrentSince Aug 23, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jan 3, 2022 Accepting new patients
Mainehealth Pediatrics Past Accepting new patients

Locations

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

119 Gannett Dr
South Portland, ME 04106
Phone (207) 773-0040

584 Roosevelt Trl
#302
Windham, ME 04062

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

Interoperability endpoints

  • Direct secure messaging: mpleacher31188@direct.mmc.mainehealth.org

Organizations & group practices 7

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1417065558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WATSON DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WATSON DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-274-0285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Gannett Dr",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041066942",
            "country_code": "US",
            "telephone_number": "207-773-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLEACHER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "ME",
            "license": "MD16483",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD16483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942854058645",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.