NPIMap

Individual provider Active NPI

Henry Calvin Martensen III, PA-C

  • Physician Assistant
  • South Portland, ME
National Provider Identifier
1669836300
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06360 Issued in NC
Practice address
119 Gannett Dr
South Portland, ME 04106-6942
Phone
(207) 781-1551
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2229 ME
Physician Assistant 363A00000X 0010-06360 NC Primary

Addresses

Primary practice location

119 Gannett Dr
South Portland, ME 04106-6942

Mailing address

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 661-2087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160601002600 NC Practitioner - Physician Assistant 8022308121 Reassigns benefits to 2 organizations
I20210907001226 ME Practitioner - Physician Assistant 8022308121 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

119 Gannett Dr
South Portland, ME 04106-6942
Phone (207) 773-0040

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

265 Western Ave
1 MMP Dermatology
South Portland, ME 04106-6942
Phone (207) 661-0100

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2229MEMDPhysician Assistant
0010-06360NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Physician Assistant CurrentSince Sep 13, 2021 Accepting new patients
Maine Medical Partners CurrentSince Sep 13, 2021 Accepting new patients
Wake Forest Health Network, LLC CurrentSince May 9, 2016 Accepting new patients
Cornerstone Health Care, LLC CurrentSince May 9, 2016 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Sep 13, 2021 Accepting new patients
Maine Medical Partners CurrentSince Sep 13, 2021 Accepting new patients
Southeastern Orthopaedic Specialists, PA Physician Assistant CurrentSince May 1, 2017 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

181 Franklin Health Cmns
#3
Farmington, ME 04938

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

119 Gannett Dr
South Portland, ME 04106
Phone (207) 773-0040

1130 N Church St
Greensboro, NC 27401
Phone (336) 272-4578

1130 N Church St
Ste 100
Greensboro, NC 27401
Phone (336) 375-2300

624 Quaker Ln
Ste 207C
High Point, NC 27262
Phone (336) 883-2500

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Interoperability endpoints

  • Direct secure messaging: hmartensen384549@direct.mmc.mainehealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1669836300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066942",
            "telephone_number": "207-661-2087",
            "fax_number": "207-781-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066942",
            "telephone_number": "207-781-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENSEN",
        "first_name": "HENRY",
        "middle_name": "CALVIN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2229",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.