Individual provider Active NPI

Gary P Degen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lincoln, ME
National Provider Identifier
1720053606
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD1023 Issued in ME
Practice address
175 W Broadway
Lincoln, ME 04457-4000
Phone
(207) 794-6700
Fax
(207) 794-6777
NPI assigned
Feb 22, 2006
Last updated
Jun 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00320 KY
Foot & Ankle Surgery Podiatrist 213ES0103X POD1023 ME Primary

Addresses

Primary practice location

175 W Broadway
Lincoln, ME 04457-4000

Mailing address

PO Box 99
Lincoln, ME 04457-0099
Phone (207) 794-6700

Other identifiers 1

IdentifierTypeStateIssuer
CH0142OtherKYRAILROAD GROUP

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141111000668 ME Practitioner - Podiatry 6406875905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

15 Gracelawn Rd
Suite 101
Auburn, ME 04210-6347
Phone (207) 333-4710

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

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue23
Removal of nail tissue351
Removal or shaving of skin growth46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018MAMDMental Health Counselor
247NHMDClinical Social Worker
00320KYMDFoot & Ankle Surgery Podiatrist
POD1023MEMDFoot & Ankle Surgery Podiatrist
274NHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Regional Medical Center CurrentSince Mar 6, 2023 Accepting new patients
St. Mary's Regional Medical Center Current Accepting new patients
St. Mary's Regional Medical Center CurrentSince Mar 6, 2023 Accepting new patients
Podiatric Physicians of Louisville PSC PastSince Aug 20, 2016 Accepting new patients

Locations

15 Gracelawn Rd
Auburn, ME 04210
Phone (207) 333-4799

15 Gracelawn Rd
Ste 101
Auburn, ME 04210
Phone (207) 333-4710

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

Organizations & group practices 5

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 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1720053606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044570099",
            "telephone_number": "207-794-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574000",
            "telephone_number": "207-794-6700",
            "fax_number": "207-794-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEN",
        "first_name": "GARY",
        "middle_name": "P",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "00320",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ME",
            "license": "POD1023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CH0142",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, ME

Sources for this page

Verify at the official NPI Registry.