NPIMap

Individual provider Active NPI

Brynn N Wajda, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Portland, ME
National Provider Identifier
1578822094
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
MD21716 Issued in ME
Practice address
15 Lowell St
Portland, ME 04102-2726
Phone
(207) 774-8277
Fax
(207) 699-5850
NPI assigned
May 4, 2012
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD21716 ME
Ophthalmology Physician 207W00000X Q8382 TX
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X MD21716 ME Primary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X MD21716 ME

Addresses

Primary practice location

15 Lowell St
Portland, ME 04102-2726

Mailing address

15 Lowell St
Portland, ME 04102-2726
Phone (207) 774-8277

Other practice location 1

161 Marginal Way
Portland, ME 04101-2438
Phone (207) 774-8277

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
I20171102000150 ME Practitioner - Ophthalmology 6709024987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Jefferson Medical College of Thomas Jefferson University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maine Eye Center PAGroup PAC ID 0446240634, shared by 2 NPIs, 19 clinicians

Practice addresses (Care Compare)

15 Lowell St
Portland, ME 04102-2726
Phone (207) 774-8277

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21716MEMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Eye Center, PA CurrentSince Nov 1, 2017 Accepting new patients
Maine Eye Center, PA CurrentSince Nov 1, 2017 Accepting new patients
Maine Eye Center, PA Ophthalmology CurrentSince Nov 1, 2017 Accepting new patients

Locations

15 Lowell St
Portland, ME 04102
Phone (207) 774-8277

161 Marginal Way
Portland, ME 04101
Phone (207) 773-7964

Interoperability endpoints

  • Direct secure messaging: bwajda183647@direct.mmc.mainehealth.org

Organizations & group practices 3

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": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1578822094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022726",
            "telephone_number": "207-774-8277",
            "fax_number": "207-699-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022726",
            "telephone_number": "207-774-8277",
            "fax_number": "207-699-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Marginal Way",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041012438",
            "country_code": "US",
            "telephone_number": "207-774-8277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAJDA",
        "first_name": "BRYNN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "MD21716",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q8382",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "ME",
            "license": "MD21716",
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "ME",
            "license": "MD21716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.