Individual provider Active NPI

Lindsey Jean Koocher, APRN- FNP

  • Family Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1740724228
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP161168 Issued in ME
Practice address
92 Campus Dr Ste C
Scarborough, ME 04074-7229
Phone
(207) 797-5753
Fax
(207) 797-9571
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN54692 ME
Family Nurse Practitioner 363LF0000X CNP161168 ME Primary

Addresses

Primary practice location

92 Campus Dr Ste C
Scarborough, ME 04074-7229

Mailing address

92 Campus Dr Ste C
Scarborough, ME 04074-7229
Phone (207) 797-5753

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127000108 ME Practitioner - Nurse Practitioner 1052693025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
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)

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

92 Campus Dr
Scarborough, ME 04074-7229

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
RN54692MEMDRegistered Nurse First Assistant
CNP161168MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 19, 2016 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Family Current Accepting new patients
Maine Medical Partners CurrentSince Dec 19, 2016 Accepting new patients
Maine Medical Partners CurrentSince Dec 19, 2016 Accepting new patients
Mainehealth CurrentSince Dec 19, 2016 Accepting new patients
Mainehealth Past Accepting new patients

Locations

1250 Forest Ave
Ste 301
Portland, ME 04103
Phone (207) 797-5753

1250 Forest Ave
Portland, ME 04103
Phone (207) 797-5753

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

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

92 Campus Dr
Ste C
Scarborough, ME 04074
Phone (207) 797-5753

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

Interoperability endpoints

  • Direct secure messaging: lclark38514@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.

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1740724228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOCHER",
        "first_name": "LINDSEY",
        "middle_name": "JEAN",
        "credential": "APRN- FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "ME",
            "license": "RN54692",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP161168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.