Individual provider Active NPI

Adam Burchard Sise, M.D.

  • Ophthalmology Physician
  • Portland, ME
National Provider Identifier
1891010997
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD20477 Issued in ME
Practice address
53 Sewall St
Portland, ME 04102-2625
Phone
(207) 828-2020
NPI assigned
Mar 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X MD20477 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

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
I20150710001146 ME Practitioner - Ophthalmology 6002033891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Medical GroupGroup PAC ID 7517995129, shared by 2 NPIs, 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
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery643

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD20477MEMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Medical Group CurrentSince Mar 1, 2022 Accepting new patients
Eyecare Medical Group Ophthalmology CurrentSince Jul 20, 2015 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

Interoperability endpoints

  • Direct secure messaging: asise@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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1891010997",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISE",
        "first_name": "ADAM",
        "middle_name": "BURCHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-31",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "MD20477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.