NPIMap

Individual provider Active NPI

Jesse Q Roberts, PA-C

  • Physician Assistant
  • Scarborough, ME
National Provider Identifier
1558529776
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
49 Spring St
1St Floor
Scarborough, ME 04074-8926
Phone
(207) 828-2100
Fax
(207) 828-2190
NPI assigned
May 23, 2008
Last updated
Jan 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X ME Primary

Addresses

Primary practice location

49 Spring St
1St Floor
Scarborough, ME 04074-8926

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other identifiers 1

IdentifierTypeStateIssuer
30338125MedicaidNH

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
I20080728000036 ME Practitioner - Physician Assistant 1850464611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

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

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jul 1, 2011 Accepting new patients
Mainehealth CurrentSince Jan 3, 2016 Accepting new patients
Mainehealth CurrentSince Jan 3, 2016 Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2011 Accepting new patients
Orthopaedic Associates of Portland, PA Past Accepting new patients
Mainehealth Past Accepting new patients
Orthopaedic Surgery Center Past Accepting new patients

Locations

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

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

49 Spring St
#1
Scarborough, ME 04074
Phone (207) 885-0011

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

584 Roosevelt Trl
#302
Windham, ME 04062

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

Interoperability endpoints

  • Direct secure messaging: jroberts9844@direct.mmc.mainehealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1558529776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 SPRING ST",
            "address_2": "1ST FLOOR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748926",
            "telephone_number": "207-828-2100",
            "fax_number": "207-828-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JESSE",
        "middle_name": "Q",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30338125",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.