Jeffrey Gagnon, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA001156 Issued in ME

Practice address

180 Kennedy Memorial Dr
Suite 101
Waterville, ME 04901-4540

Phone

(207) 861-7874

Fax

(207) 861-4646

NPI assigned

Mar 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Yale University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score

90.63 of 100Reported as group

Quality

77.69

Promoting interoperability

95

Improvement activities

40

Cost

78.59

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffreygagnon@mgh.allscriptsdirect.net

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment Care Compare group NPD
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1083949184
  NPD
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1811137888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "address_2": "SUITE 101",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014540",
            "telephone_number": "207-861-7874",
            "fax_number": "207-861-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "address_2": "SUITE 101",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014540",
            "telephone_number": "207-861-7874",
            "fax_number": "207-861-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "JEFFREY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA001156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "PA001156",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Furrow
• Antonella Fusco
• Paul D Gagliardi, M.D.
• Timothy J Gagne, MD
• Danielle Paige Gagnon, M.D.
• Paulette L. Gagnon, R.N.
• Steven Raymond Gagnon, D.C.
• Jon D. Gallagher, LADC
• Fernald Timothy Garland, PA-C
• John Garofalo, MD

• Surgical Physician Assistant in Waterville, ME
• Providers in Waterville, ME by specialty
• Surgical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.