Individual provider Active NPI

John Cooper III, DO

  • Family Medicine Physician
  • Augusta, ME
National Provider Identifier
1649764341
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO3004 Issued in ME
Practice address
35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone
(207) 248-5000
Fax
(207) 626-1648
NPI assigned
Jun 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP18009 ME
Family Medicine Physician 207Q00000X DO3004 ME Primary

Addresses

Primary practice location

35 Medical Center Pkwy
Augusta, ME 04330-8160

Mailing address

35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone (207) 248-5000

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629002223 ME Practitioner - Emergency Medicine 5890045348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3004MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Maine Medical Consultants PC CurrentSince Sep 1, 2023 Accepting new patients
Mainegeneral Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Central Maine Medical Center Past Accepting new patients
Central Maine Medical Center Past Accepting new patients
VK Augusta, LLC Past Accepting new patients

Locations

188 Eastern Ave
Augusta, ME 04330
Phone (207) 622-3121

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

367 US Route 1
Ste 3S
Falmouth, ME 04105
Phone (207) 939-6789

335 Brighton Ave
Portland, ME 04102
Phone (207) 662-8000

91 Auburn St
Ste J1096
Portland, ME 04103
Phone (207) 939-6789

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: john.cooper@xdr.hhchealthdirect.org

Organizations & group practices 6

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1649764341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-248-5000",
            "fax_number": "207-626-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-248-5000",
            "fax_number": "207-626-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JOHN",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "TP18009",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO3004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.