Individual provider Active NPI

Frederick Clapp Roediger, M.D.

  • Otolaryngology Physician
  • Portland, ME
National Provider Identifier
1659409977
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD18047 Issued in ME
Practice address
1250 Forest Ave
Suite 301
Portland, ME 04103-1897
Phone
(207) 797-5753
Fax
(207) 797-9571
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD18047 ME Primary

Addresses

Primary practice location

1250 Forest Ave
Suite 301
Portland, ME 04103-1897

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other identifiers 5

IdentifierTypeStateIssuer
30209197OtherMENEW HAMPSHIRE MEDICAID
P00759644OtherMERAILROAD MEDICARE GROUP PTAN
1044199OtherMEAETNA
AA146929OtherMEHARVARD PILGRIM
433941099MedicaidME

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
I20091005000361 ME Practitioner - Otolaryngology 2163568122 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2004
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)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

30 W Cole Rd
Biddeford, ME 04005-9453
Phone (207) 284-6673

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315

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
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18047MEMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Aug 1, 2019 Accepting new patients
Maine Medical Partners CurrentSince Aug 1, 2019 Accepting new patients
Mainehealth CurrentSince Aug 1, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners Otolaryngology CurrentSince Aug 1, 2019 Accepting new patients
Mainehealth Current Accepting new patients

Locations

1250 Forest Ave
Ste 301
Portland, ME 04103
Phone (207) 797-5753

1250 Forest Ave
Portland, ME 04103
Phone (207) 797-5753

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

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: froediger27285@direct.mmc.mainehealth.org

Organizations & group practices 7

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1659409977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 FOREST AVE",
            "address_2": "SUITE 301",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031897",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDIGER",
        "first_name": "FREDERICK",
        "middle_name": "CLAPP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "MD18047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW HAMPSHIRE MEDICAID",
            "identifier": "30209197",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "P00759644",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1044199",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA146929",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433941099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.