NPIMap

Individual provider Active NPI

Kathy Bouton Semmel, PA

  • Physician Assistant
  • Hampden, ME
National Provider Identifier
1851300255
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1051 Issued in ME
Practice address
21 Western Ave
Hampden, ME 04444-1422
Phone
(207) 862-0300
Fax
(207) 907-1041
NPI assigned
Aug 5, 2006
Last updated
Feb 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1051 ME Primary

Addresses

Primary practice location

21 Western Ave
Hampden, ME 04444-1422

Mailing address

C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8560

Other identifiers 1

IdentifierTypeStateIssuer
300640099MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kboutonsemmel613659@direct-prd.goodhelpconnections.org

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
I20040503001187 ME Practitioner - Physician Assistant 5799773354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

21 Western Ave
St Joseph Family Medicine Hampden
Hampden, ME 04444-1422
Phone (207) 862-0330

360 Broadway
Bangor, ME 04401-3979

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1051MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Ambulatory Care Inc Past Accepting new patients
Sunbury Primary Care, P.a. Physician Assistant Past Accepting new patients
Sunbury Primary Care, P.a. Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kboutonsemmel1149641@direct.bsmhealth.org

Organizations & group practices 4

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 5

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1851300255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8560",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WESTERN AVE",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441422",
            "telephone_number": "207-862-0300",
            "fax_number": "207-907-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTON SEMMEL",
        "first_name": "KATHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300640099",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kboutonsemmel613659@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "21 Western Ave",
            "city": "Hampden",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044441422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hampden, ME

Sources for this page

Verify at the official NPI Registry.