NPIMap

Individual provider Active NPI

Caroline Cappelaere Desroches, PA-C

  • Physician Assistant
  • North Conway, NH
National Provider Identifier
1871820183
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2081 Issued in NH
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-5472
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054151 PA
Physician Assistant 363A00000X PA1387 ME
Medical Physician Assistant 363AM0700X C5-0000691 DE
Physician Assistant 363A00000X 2081 NH Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

3073 White Mountain Hwy
North Conway, NH 03860-7101

Other practice location 1

25 Hospital Dr
Bridgton, ME 04009-1167
Phone (207) 647-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140825001751 ME Practitioner - Physician Assistant 8729206206 Reassigns benefits to 2 organizations
I20231016002488 NH Practitioner - Physician Assistant 8729206206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 2365418993, 79 clinicians

Practice addresses (Care Compare)

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

Hospital & facility affiliations

  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

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

State licenses

LicenseStateTypeSpecialty
2081NHMDMental Health Counselor
PA1387MEMDSpecialist
MA054151PAMDPhysician Assistant
C5-0000691DEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Feb 14, 2018 Accepting new patients
Bridgton Hospital CurrentSince Jul 7, 2014 Accepting new patients
Memorial Hospital CurrentSince Aug 23, 2023 Accepting new patients
Memorial Hospital CurrentSince Aug 23, 2023 Accepting new patients

Locations

931 Union St
Fl 3
Bangor, ME 04401

25 Hospital Dr
Bridgton, ME 04009
Phone (207) 524-3501

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

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

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

Interoperability endpoints

  • Direct secure messaging: cdesroches601181@direct.mmc.mainehealth.org

Organizations & group practices 6

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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1871820183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgton",
            "state": "ME",
            "postal_code": "040091167",
            "country_code": "US",
            "telephone_number": "207-647-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESROCHES",
        "first_name": "CAROLINE",
        "middle_name": "CAPPELAERE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054151",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1387",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C5-0000691",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.