NPIMap

Individual provider Active NPI

Mark Ouellette, FNP-C

  • Family Nurse Practitioner
  • Kennebunk, ME
National Provider Identifier
1447649280
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP151002 Issued in ME
Practice address
2 Livewell Drive - North Tower
Kennebunk, ME 04043
Phone
(207) 467-6900
NPI assigned
Jan 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP151002 ME
Family Nurse Practitioner 363LF0000X CNP151002 ME Primary

Addresses

Primary practice location

2 Livewell Drive - North Tower
Kennebunk, ME 04043

Mailing address

PO Box 1638
Albany, NY 12201-1638
Phone (207) 777-4111

Other practice location 1

144 State St
Portland, ME 04101-3776
Phone (207) 879-3190

Other practice location 2

91 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8120

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
I20151015000008 ME Practitioner - Nurse Practitioner 4486971348 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

10 Goodall Dr
Suite 900
East Waterboro, ME 04030-5233
Phone (207) 490-7760

19 S Gorham Xing
Gorham, ME 04038-2690
Phone (207) 535-1400

2 Livewell Dr
Kennebunk, ME 04043-6762
Phone (207) 467-8988

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

25 A June St
Sanford, ME 04073-2642

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

409 Roosevelt TRL
Windham, ME 04062-4821
Phone (207) 400-8600

655 Main St
Saco, ME 04072-1699
Phone (207) 294-5959

Hospital & facility affiliations

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

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

State licenses

LicenseStateTypeSpecialty
CNP151002MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Nov 25, 2022 Accepting new patients
Mercy Hospital CurrentSince Mar 9, 2015 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainegeneral Medical Center CurrentSince Jun 1, 2020 Accepting new patients
Mainehealth CurrentSince Feb 5, 2018 Accepting new patients
Mainehealth Family CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Feb 5, 2018 Accepting new patients
Mercy Hospital CurrentSince Mar 9, 2015 Accepting new patients
Mainegeneral Medical Center CurrentSince Jun 1, 2020 Accepting new patients
Mainehealth Current Accepting new patients
Central Maine Medical Center CurrentSince Nov 25, 2022 Accepting new patients
Central Maine Medical Center Current Accepting new patients

Locations

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

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

2 Livewell Dr
Kennebunk, ME 04043
Phone (207) 467-6900

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

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4420

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

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

105 Topsham Fair Mall Rd
Unit 8
Topsham, ME 04086
Phone (207) 798-6300

149 North St
Waterville, ME 04901
Phone (207) 622-1959

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

950 Main St
Westbrook, ME 04092
Phone (207) 517-3800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: mouellette99278@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 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": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1447649280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1638",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011638",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DRIVE - NORTH TOWER",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "04043",
            "telephone_number": "207-467-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 State St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013776",
            "country_code": "US",
            "telephone_number": "207-879-3190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "91 Campus Ave",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ME",
            "postal_code": "042406030",
            "country_code": "US",
            "telephone_number": "207-777-8120",
            "fax_number": "207-777-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "MARK",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-16",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP151002",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP151002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

Verify at the official NPI Registry.