John Tivnan, D.O.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

DO3257 Issued in ME

Practice address

1365 Broadway
Bangor, ME 04401-2401

Phone

(207) 942-6226

Fax

(207) 992-2756

NPI assigned

May 24, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

University of New England, College of Osteo Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Pain Management PCGroup PAC ID 1759355860, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.26 of 100Reported as group

Quality

96.06

Improvement activities

40

Cost

77.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Northeast Pain Management, PC

  • Interventional Pain Medicine Physician
  • Bangor, ME
  • NPI 1578579868

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1518315142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012401",
            "telephone_number": "207-942-6226",
            "fax_number": "207-992-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012401",
            "telephone_number": "207-942-6226",
            "fax_number": "207-992-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIVNAN",
        "first_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "ME",
            "license": "DO3257",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "ME",
            "license": "DO3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brianna Tipping, CADC
• Lenore Marie Tipping, PH.D.
• Gaston To'Olo, D.M.D.
• Ivy A G Todd, PNPC
• Katie Lynn Todd
• Meredith L Todd, MD
• Sophie Todd, D.O

• Interventional Pain Medicine Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Interventional Pain Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.