Individual provider Active NPI

John Kenneth Lippincott, MD

  • Ophthalmology Physician
  • Portland, ME
National Provider Identifier
1871094110
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD28019 Issued in ME
Practice address
53 Sewall St
Portland, ME 04102-2625
Phone
(207) 828-2020
Fax
(207) 773-7034
NPI assigned
Feb 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 76892 WI
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 76892 WI
Ophthalmology Physician 207W00000X MD28019 ME Primary

Addresses

Primary practice location

53 Sewall St
Portland, ME 04102-2625

Mailing address

53 Sewall St
Portland, ME 04102-2625
Phone (207) 828-2020

Other practice location 1

925 N 87th St
Milwaukee, WI 53226-4812
Phone (414) 955-2020

Other practice location 2

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2020

Other identifiers 2

IdentifierTypeStateIssuer
1871094110MedicaidME
1871094110MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220716000448 WI Practitioner - Ophthalmology 0244642924 Reassigns benefits to 1 organization
I20240618002480 ME Practitioner - Ophthalmology 0244642924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Mississippi School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Medical GroupGroup PAC ID 7517995129, 9 clinicians

Practice addresses (Care Compare)

53 Sewall St
Portland, ME 04102-2625
Phone (207) 828-2020

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28019MEMDOphthalmology Physician
76892WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 5, 2022 Accepting new patients
Eyecare Medical Group Ophthalmology CurrentSince Jun 1, 2024 Accepting new patients

Locations

53 Sewall St
Portland, ME 04102
Phone (207) 350-5019

655 Main St
Ste 2
Saco, ME 04072
Phone (207) 828-2020

925 N 87th St
Milwaukee, WI 53226
Phone (414) 955-2020

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Interoperability endpoints

  • Direct secure messaging: jlippincott@eyecaremed.intellechartdirect.net

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1871094110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022625",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022625",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 N 87th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264812",
            "country_code": "US",
            "telephone_number": "414-955-2020",
            "fax_number": "414-955-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-266-2020",
            "fax_number": "414-266-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPPINCOTT",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "76892",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "WI",
            "license": "76892",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "MD28019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871094110",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871094110",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.