Individual provider Active NPI

Doreen F Gagne, NP

  • Family Nurse Practitioner
  • Bel Air, MD
National Provider Identifier
1588701486
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R094550 Issued in MD
Practice address
520 Upper Chesapeake Dr Ste 206
Bel Air, MD 21014-4360
Phone
(410) 879-9100
Fax
(410) 838-3853
NPI assigned
Jan 31, 2007
Last updated
May 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R094550 MD Primary

Addresses

Primary practice location

520 Upper Chesapeake Dr Ste 206
Bel Air, MD 21014-4360

Mailing address

520 Upper Chesapeake Dr Ste 206
Bel Air, MD 21014-4360
Phone (443) 433-6663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000713 MD Practitioner - Nurse Practitioner 7911062880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Bay ENT and Audiology Group LLCGroup PAC ID 0840646717, 11 clinicians

Practice addresses (Care Compare)

456 Alliance St
Havre de Grace, MD 21078-3559
Phone (410) 939-1819

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.58 of 100Reported as group
Quality
82.37
Improvement activities
40
Cost
78.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R094550MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Bay ENT & Audiology Group LLC Otolaryngology CurrentSince May 18, 2024 Accepting new patients
Entaa Care, P.a. Past Accepting new patients
Lancaster Ear Nose and Throat LLC Otolaryngology Past Accepting new patients

Locations

520 Upper Chesapeake Dr
Ste 206
Bel Air, MD 21014
Phone (410) 879-9100

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 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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1588701486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144360",
            "telephone_number": "443-433-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144360",
            "telephone_number": "410-879-9100",
            "fax_number": "410-838-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "DOREEN",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R094550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.