NPIMap

Individual provider Active NPI

Karen Anne Phelps, NP

  • Adult Health Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1588801773
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
141081 Issued in ME
Practice address
100 Campus Dr
Suite 121
Scarborough, ME 04074-7171
Phone
(207) 396-7786
NPI assigned
Jan 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 141081 ME Primary
Adult Health Nurse Practitioner 363LA2200X 186064 MA

Addresses

Primary practice location

100 Campus Dr
Suite 121
Scarborough, ME 04074-7171

Mailing address

100 Campus Dr
Suite 121
Scarborough, ME 04074-7171

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
I20150428001457 ME Practitioner - Nurse Practitioner 9638355480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

100 Campus Dr
Scarborough, ME 04074-7172

22 Bramhall St
Portland, ME 04102-3134

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
186064MAMDAdult Health Nurse Practitioner
141081MEMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 18, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Sep 18, 2014 Accepting new patients
Mainehealth CurrentSince Sep 18, 2014 Accepting new patients
Mainehealth Adult Health Current Accepting new patients

Locations

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

100 Campus Dr
Unit 121
Scarborough, ME 04074
Phone (207) 396-7760

Interoperability endpoints

  • Direct secure messaging: kgronberg112260@direct.mmc.mainehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1231545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1588801773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMPUS DR",
            "address_2": "SUITE 121",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS DR",
            "address_2": "SUITE 121",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747171",
            "telephone_number": "207-396-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KAREN",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-10",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "141081",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "186064",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.