Individual provider Active NPI

Courtney C. Macleod, PA-C

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1760824270
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1418 Issued in ME
Practice address
15 Captains LNDG
Portland, ME 04102-1961
Phone
(207) 831-5169
NPI assigned
Jul 25, 2013
Last updated
Apr 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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 PA1418 ME Primary

Addresses

Primary practice location

15 Captains LNDG
Portland, ME 04102-1961

Mailing address

15 Captains LNDG
Portland, ME 04102-1961
Phone (207) 831-5169

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
I20131023001492 ME Practitioner - Physician Assistant 5597990762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of New England, College of Osteo Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Maine CurrentSince Mar 30, 2015 Accepting new patients
State of Maine CurrentSince Mar 30, 2015 Accepting new patients
Mercy Hospital CurrentSince Aug 19, 2013 Accepting new patients
Mercy Hospital CurrentSince Aug 19, 2013 Accepting new patients

Locations

109 Capitol St
#11
Augusta, ME 04330

656 State St
Bangor, ME 04401
Phone (207) 941-4000

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

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 2

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": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1760824270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CAPTAINS LNDG",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021961",
            "telephone_number": "207-831-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CAPTAINS LNDG",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021961",
            "telephone_number": "207-831-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEOD",
        "first_name": "COURTNEY",
        "middle_name": "C.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.