Individual provider Active NPI

Herman James Stegeman, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1629091806
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC546 Issued in ME
Practice address
180 Frances St
Portland, ME 04102-2549
Phone
(207) 632-4798
Fax
(207) 773-3505
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC546 ME Primary

Addresses

Primary practice location

180 Frances St
Portland, ME 04102-2549

Mailing address

180 Frances St
Portland, ME 04102-2549
Phone (207) 632-4798

Other identifiers 1

IdentifierTypeStateIssuer
008416OtherMEANTHEM BLUE CROSS BLUE SH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000319 ME Practitioner - Clinical Social Worker 2668416587 Practice locations: Portland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 Frances St
Portland, ME 04102-2549
Phone (207) 632-4798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Brunswick Physical Therapy P.a. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1629091806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 FRANCES ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022549",
            "telephone_number": "207-632-4798",
            "fax_number": "207-773-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FRANCES ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022549",
            "telephone_number": "207-632-4798",
            "fax_number": "207-773-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGEMAN",
        "first_name": "HERMAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "008416",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.