NPIMap

Individual provider Active NPI

Martin Lee Shott, PA-C

  • Surgical Physician Assistant
  • Scarborough, ME
National Provider Identifier
1780250373
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2963 Issued in ME
Practice address
92 Campus Dr Ste a
Scarborough, ME 04074-7229
Phone
(207) 885-0011
Fax
(207) 885-5851
NPI assigned
Jun 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA8181 MA
Surgical Physician Assistant 363AS0400X PA2963 ME Primary
Physician Assistant 363A00000X PA2963 ME

Addresses

Primary practice location

92 Campus Dr Ste a
Scarborough, ME 04074-7229

Mailing address

92 Campus Dr Ste a
Scarborough, ME 04074-7229
Phone (207) 885-0011

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-0605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210907000822 MA Practitioner - Physician Assistant 8820494578 Reassigns benefits to 1 organization
I20260210000949 ME Practitioner - Physician Assistant 8820494578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

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

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8181MAMDPhysician Assistant
PA2963MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 30, 2026 Accepting new patients
Mainehealth CurrentSince Mar 30, 2026 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Sep 6, 2021 Accepting new patients

Locations

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

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

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

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 and National Provider Directory roles.

Hospital & facility affiliations 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1780250373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-885-0011",
            "fax_number": "207-885-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-885-0011",
            "fax_number": "207-885-5851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-0605",
            "fax_number": "508-856-5074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOTT",
        "first_name": "MARTIN",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-03",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8181",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA2963",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.