Individual provider Active NPI

Stephen P Clark, M.D.

  • Orthopaedic Surgery Physician
  • Auburn, ME
National Provider Identifier
1508276445
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD21734 Issued in ME
Practice address
690 Minot Ave
Auburn, ME 04210-3922
Phone
(207) 783-1328
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD21734 ME Primary

Addresses

Primary practice location

690 Minot Ave
Auburn, ME 04210-3922

Mailing address

324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (617) 314-1111

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
I20170710001203 ME Practitioner - Orthopedic Surgery 2163718776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Massachusetts Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1870

Hospital & facility affiliations

  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion15
Laminectomy or laminotomy (partial removal of spine bones)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21734MEMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Jan 1, 2020 Accepting new patients
Mainegeneral Medical Center CurrentSince Jan 1, 2020 Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

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

15 Enterprise Dr
Ste 100
Augusta, ME 04330
Phone (207) 621-7500

107 First Park Dr
Oakland, ME 04963
Phone (207) 621-8700

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

Interoperability endpoints

  • Direct secure messaging: stephenclark@mgh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508276445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-1328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "617-314-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "MD21734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.