Individual provider Active NPI

Samuel Madore, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Waterville, ME
National Provider Identifier
1831537109
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
DO2620 Issued in ME
Practice address
149 North St
Waterville, ME 04901-4974
Phone
(207) 861-5101
Fax
(207) 872-4341
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO2620 ME Primary
Student in an Organized Health Care Education/Training Program 390200000X TP13121 ME

Addresses

Primary practice location

149 North St
Waterville, ME 04901-4974

Mailing address

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160824002811 ME Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 3870737778 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TP13121MEMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients
Mainegeneral Medical Center CurrentSince Jul 1, 2016 Accepting new patients
Mainehealth CurrentSince Aug 12, 2019 Accepting new patients
Mainehealth CurrentSince Aug 12, 2019 Accepting new patients
Hospital Manipulative Service PA Neuromusculoskeletal Medicine & Omm Past Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

119 Northport Ave
Fl 1
Belfast, ME 04915
Phone (207) 505-4567

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

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831537109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 NORTH ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014974",
            "telephone_number": "207-861-5101",
            "fax_number": "207-872-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADORE",
        "first_name": "SAMUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "DO2620",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": "TP13121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.