NPIMap

Individual provider Active NPI

Alexis Glassman, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1689364663
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
CNP221515 Issued in ME
Practice address
102 Campus Ave
Lewiston, ME 04240-6019
Phone
(207) 777-4200
NPI assigned
May 11, 2023
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X CNP221515 ME Primary

Addresses

Primary practice location

102 Campus Ave
Lewiston, ME 04240-6019

Mailing address

207 Hope Ave
Portland, ME 04103-2295
Phone (661) 373-6687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20230622002431 ME Practitioner - Nurse Practitioner 2466810494 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Health Me, LLCGroup PAC ID 9133463490, 18 clinicians
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

370 Portland St
Yarmouth, ME 04096-8101
Phone (203) 497-3861

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8100

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP221515MEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Medical Services of New England Inc CurrentSince May 18, 2023 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Impact Health Me, LLC CurrentSince Nov 1, 2025 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

14 Westport Ave
Norwalk, CT 06851
Phone (203) 497-3867

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

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

102 Campus Ave
Lewiston, ME 04240
Phone (207) 777-4200

91 Campus Ave
Lewiston, ME 04240
Phone (207) 777-8150

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

370 Portland St
Yarmouth, ME 04096
Phone (207) 846-9021

Organizations & group practices 4

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1689364663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HOPE AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032295",
            "telephone_number": "661-373-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406019",
            "telephone_number": "207-777-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSMAN",
        "first_name": "ALEXIS",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP221515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.