NPIMap

Individual provider Active NPI

Brian A Lawhead, PA-C

  • Surgical Physician Assistant
  • Portland, ME
National Provider Identifier
1770578171
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA506 Issued in ME
Practice address
335 Brighton Ave
Suite 200
Portland, ME 04103-2362
Phone
(207) 662-8600
Fax
(207) 662-8668
NPI assigned
Sep 13, 2005
Last updated
Apr 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA506 ME Primary

Addresses

Primary practice location

335 Brighton Ave
Suite 200
Portland, ME 04103-2362

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

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
I20080521000324 ME Practitioner - Physician Assistant 8921177973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
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

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

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA506MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 15, 2015 Accepting new patients
Mainehealth CurrentSince Nov 15, 2015 Accepting new patients
Orthopaedic Associates of Portland, PA Past Accepting new patients
Orthopaedic Surgery Center Past Accepting new patients

Locations

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

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

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

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

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

584 Roosevelt Trl
#302
Windham, ME 04062

Interoperability endpoints

  • Direct secure messaging: blawhead31155@direct.mmc.mainehealth.org

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1770578171",
    "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",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "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": "041032362",
            "telephone_number": "207-662-8600",
            "fax_number": "207-662-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWHEAD",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.