NPIMap

Individual provider Active NPI

Andrew Guppy, PA

  • Physician Assistant
  • Winterport, ME
National Provider Identifier
1679582126
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA371 Issued in ME
Practice address
775 N Main St
Winterport, ME 04496
Phone
(207) 223-5074
Fax
(207) 223-5953
NPI assigned
Aug 5, 2006
Last updated
Nov 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA371 ME Primary

Addresses

Primary practice location

775 N Main St
Winterport, ME 04496

Mailing address

PO Box 921
Bangor, ME 04402-0921
Phone (207) 942-7650

Other identifiers 1

IdentifierTypeStateIssuer
276740099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20231107001285 NV Practitioner - Physician Assistant 1153492483 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carson Valley Medical Center Rural Health ClinicGroup PAC ID 2860579984, 43 clinicians

Practice addresses (Care Compare)

1520 Virginia Ranch Rd
Gardnerville, NV 89410-5731
Phone (775) 782-1550

897 Ironwood Dr
Minden, NV 89423-5198
Phone (775) 782-1610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as apm
Quality
81.42
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA371MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washoe Barton Medical Clinic a Nevada Nonprofit Corporation Past Accepting new patients
Sunbury Primary Care, P.a. Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aguppy200029@direct.renown.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1679582126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 921",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020921",
            "telephone_number": "207-942-7650",
            "fax_number": "207-990-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 N MAIN ST",
            "city": "WINTERPORT",
            "state": "ME",
            "postal_code": "04496",
            "telephone_number": "207-223-5074",
            "fax_number": "207-223-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPPY",
        "first_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276740099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winterport, ME

Sources for this page

Verify at the official NPI Registry.