NPIMap

Individual provider Active NPI

Leah Deandrea Waldman, PAC

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1871560821
Registry record updated Jul 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1601 Issued in ME
Practice address
144 State St
Portland, ME 04101-3776
Phone
(207) 879-3000
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00160900 NJ
Physician Assistant 363A00000X PA1601 ME Primary

Addresses

Primary practice location

144 State St
Portland, ME 04101-3776

Mailing address

28 Newell Ridge Rd
Cumberland, ME 04021-3915
Phone (267) 981-5300

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
I20160829001552 ME Practitioner - Physician Assistant 8527073261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

195 Fore River Pkwy
Suite 440
Portland, ME 04102-2788
Phone (207) 553-6054

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00160900NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Jul 11, 2016 Accepting new patients
Princeton Emergency Physicians, PA Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

195 Fore River Pkwy
Ste 440
Portland, ME 04102
Phone (207) 553-6920

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

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 and National Provider Directory roles.

Hospital & facility affiliations 43

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1871560821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 NEWELL RIDGE RD",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040213915",
            "telephone_number": "267-981-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "LEAH",
        "middle_name": "DEANDREA",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00160900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.