NPIMap

Individual provider Active NPI

Jeffrey C Bedrosian, MD

  • Otolaryngology Physician
  • Portland, ME
National Provider Identifier
1821252974
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD19186 Issued in ME
Practice address
1250 Forest Ave
Portland, ME 04103
Phone
(207) 797-5753
Fax
(207) 797-9571
NPI assigned
Jul 17, 2008
Last updated
Nov 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 188377 PA
Otolaryngology Physician 207Y00000X MD19186 ME Primary

Addresses

Primary practice location

1250 Forest Ave
Portland, ME 04103

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20161205000668 PA Practitioner - Otolaryngology 9830345636 Reassigns benefits to 3 organizations
I20170410000990 NJ Practitioner - Otolaryngology 9830345636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Associates, LLCGroup PAC ID 6204012016, 43 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

3445 High Point Blvd
Suite 400
Bethlehem, PA 18017-7808

3445 High Point Blvd
Suite 400
Bethlehem, PA 18017-7817
Phone (610) 866-5555

511 E 3Rd St
200 St Lukes Southside Medical Center
Bethlehem, PA 18015-2095
Phone (484) 526-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD19186MEMDOtolaryngology Physician
188377PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Community Health, Inc CurrentSince Mar 26, 2019 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Dec 1, 2016 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
Specialty Physician Associates, LLC Otolaryngology CurrentSince Dec 1, 2016 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Apr 1, 2017 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Apr 1, 2017 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 1, 2016 Accepting new patients
Star Community Health, Inc Otolaryngology CurrentSince Mar 26, 2019 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

3445 High Point Blvd
Ste 400
Bethlehem, PA 18017
Phone (610) 824-5050

511 E 3rd St
Ste 200
Bethlehem, PA 18015
Phone (484) 526-4700

511 E 3rd St
Ste 301
Bethlehem, PA 18015
Phone (484) 526-2460

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/76651

Organizations & group practices 9

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 9

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1821252974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE ONE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "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": "1250 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-797-5753",
            "fax_number": "207-797-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDROSIAN",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "188377",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ME",
            "license": "MD19186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.