Individual provider Active NPI

James P Theberge, M.D.

  • Internal Medicine Physician
  • Westbrook, ME
National Provider Identifier
1881635001
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
016282 Issued in ME
Practice address
40 Park Rd
Westbrook, ME 04092-3188
Phone
(207) 857-8174
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016282 ME Primary

Addresses

Primary practice location

40 Park Rd
Westbrook, ME 04092-3188

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
ME0110MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040731000248 ME Practitioner - Internal Medicine 4587556055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1986
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

19 S Gorham Xing
Gorham, ME 04038-2690
Phone (207) 535-1400

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

409 Roosevelt TRL
Windham, ME 04062-4821
Phone (207) 400-8600

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
016282MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Aug 1, 2003 Accepting new patients
Mercy Hospital CurrentSince Aug 1, 2003 Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

19 S Gorham Xing
Gorham, ME 04038
Phone (207) 535-1400

616 Forest Ave
Portland, ME 04101
Phone (207) 761-6910

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

Organizations & group practices 3

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 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1881635001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PARK RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923188",
            "telephone_number": "207-857-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PARK RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923188",
            "telephone_number": "207-857-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBERGE",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "016282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ME0110",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.