NPIMap

Individual provider Active NPI

Gregory Blaisdell, MD

  • Orthopaedic Surgery Physician
  • Portland, ME
National Provider Identifier
1689864233
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
16000 Issued in NH
Practice address
335 Brighton Ave
Suite 200
Portland, ME 04102-2363
Phone
(207) 662-8600
Fax
(207) 662-8668
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD20727 ME
Surgery Physician 208600000X ML20008868 WA
Orthopaedic Surgery Physician 207X00000X ME112516 FL
Orthopaedic Surgery Physician 207X00000X 16000 NH Primary

Addresses

Primary practice location

335 Brighton Ave
Suite 200
Portland, ME 04102-2363

Mailing address

301C US Route 1
Scarborough, ME 04074-9701

Other identifiers 5

IdentifierTypeStateIssuer
14L3JOtherFLBC/BS
3086827MedicaidNH
PENDINGOtherFLAETNA
PENDINGOtherFLCIGNA
1689864233MedicaidFL

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
I20150929001685 ME Practitioner - Orthopedic Surgery 5991960064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Pennsylvania State University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mainehealth 2,616 clinicians

Practice addresses (Care Compare)

335 Brighton Ave
Portland, ME 04102-2363
Phone (207) 662-8000

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307

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
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20008868WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Maine Medical Partners Surgery Current Accepting new patients
Maine Medical Partners Surgery CurrentSince Sep 5, 2015 Accepting new patients
Mainehealth CurrentSince Sep 5, 2015 Accepting new patients
Mainehealth CurrentSince Sep 5, 2015 Accepting new patients
Maine Medical Partners Orthopaedic Surgery CurrentSince Sep 5, 2015 Accepting new patients
Mainehealth Past Accepting new patients

Locations

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

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

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

335 Brighton Ave
Ste 200
Portland, ME 04102
Phone (207) 662-8600

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

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

Interoperability endpoints

  • Direct secure messaging: gblaisdell126302@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 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1689864233",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022363",
            "telephone_number": "207-662-8600",
            "fax_number": "207-662-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "MD20727",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML20008868",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME112516",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NH",
            "license": "16000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "14L3J",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086827",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689864233",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.