Individual provider Active NPI

John F Vanadia, DO

  • Surgery Physician
  • Bangor, ME
National Provider Identifier
1497818868
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1149 Issued in ME
Practice address
360 Broadway
Bangor, ME 04401-3979
Phone
(207) 907-3650
Fax
(207) 907-3660
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1149 ME Primary

Addresses

Primary practice location

360 Broadway
Bangor, ME 04401-3979

Mailing address

C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8560

Other identifiers 3

IdentifierTypeStateIssuer
040754OtherMEANTHEM BS ID
234340099MedicaidME
2677016OtherMECIGNA ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvanadia613822@direct-prd.goodhelpconnections.org

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
I20050727000608 ME Practitioner - General Surgery 2062440548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of New England, College of Osteo Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

360 Broadway
Bangor, ME 04401-3979
Phone (207) 907-1617

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Hernia repair - groin (open)12
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1149MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Hospital CurrentSince Dec 12, 2020 Accepting new patients

Locations

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

358 Broadway
Ste 204
Bangor, ME 04401

358 Broadway
Ste 306
Bangor, ME 04401
Phone (207) 907-3660

Interoperability endpoints

  • Direct secure messaging: jvanadia1156567@direct.bsmhealth.org

Organizations & group practices 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1497818868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8560",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013979",
            "telephone_number": "207-907-3650",
            "fax_number": "207-907-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANADIA",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "1149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BS ID",
            "identifier": "040754",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234340099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "2677016",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvanadia613822@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.