Individual provider Active NPI

Kelly Lynch, M.A

  • Audiologist
  • Portland, ME
National Provider Identifier
1861403263
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AP815 Issued in ME
Practice address
43 Baxter Blvd
Portland, ME 04101-1823
Phone
(207) 775-6381
Fax
(207) 775-3378
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AP815 ME Primary

Addresses

Primary practice location

43 Baxter Blvd
Portland, ME 04101-1823

Mailing address

43 Baxter Blvd
Portland, ME 04101-1823
Phone (207) 775-6381

Other identifiers 4

IdentifierTypeStateIssuer
431565800MedicaidME
110570100MedicaidME
110570101MedicaidME
325660099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080916000271 ME Practitioner - Qualified Audiologist 4587731633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
John M. O'Day Current Accepting new patients
Mercy Hospital Current Accepting new patients

Locations

195 Fore River Pkwy
Ste 210
Portland, ME 04102
Phone (207) 535-1150

43 Baxter Blvd
Portland, ME 04101
Phone (207) 775-6381

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

361 High St
Somersworth, NH 03878
Phone (603) 692-4500

Organizations & group practices 2

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861403263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011823",
            "telephone_number": "207-775-6381",
            "fax_number": "207-775-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011823",
            "telephone_number": "207-775-6381",
            "fax_number": "207-775-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KELLY",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ME",
            "license": "AP815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431565800",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110570100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110570101",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325660099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.