Active NPI
Brian J Keroack, MD
- Specialist
- Portland, ME
National Provider Identifier
1891788659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 013245
- Practice address
- 51 Sewall St
Portland, ME 04102-2643 - Phone
- (207) 774-5761
- Fax
- (207) 874-7478
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 013245 | ME | Primary |
Addresses
Primary practice location
51 Sewall St
Portland, ME 04102-2643
Mailing address
51 Sewall St
Portland, ME 04102-2643
Phone (207) 774-5761
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0673610001 | Other | ME | DMERC |
| 269530099 | Medicaid | ME | |
| 660000685 | Other | ME | PALMETTO RAILROAD MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Tufts University School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12 Hospital Dr
Suite C
York, ME 03909-1030
Phone (207) 351-3975
51 Sewall St
Portland, ME 04102-2643
Phone (207) 774-5761
Hospital & facility affiliations
- York Hospital
- Mainehealth Maine Medical Center
- Memorial Hospital, the
- Mainehealth Stephens Hospital
- Mainehealth Mid Coast Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.74 of 100
- Quality
- 91.48
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013245 | ME | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| York Hospital | Current | Accepting new patients | |
| Rheumatology Associates P.a. | Specialist | Current | Accepting new patients |
| Mainegeneral Health Associates | Past | Accepting new patients |
Locations
51 Sewall St
Portland, ME 04102
Phone (207) 774-5761
12 Hospital Dr
Ste C
York, ME 03909
Phone (207) 351-2063
15 Hospital Dr
York, ME 03909
Phone (207) 351-2478
Interoperability endpoints
- brian.keroack.p1@direct.rheumme.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Specialist
- Portland, ME
- NPI 1003098252
-
- General Acute Care Hospital
- York, ME
- NPI 1376528398
-
- Rheumatology Physician
- Gardiner, ME
- NPI 1659337905
Hospital & facility affiliations 44
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
-
- Critical Access Hospital
- Norway, ME
- NPI 1346299815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223510400000",
"number": "1891788659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 SEWALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022643",
"telephone_number": "207-774-5761",
"fax_number": "207-874-7478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SEWALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022643",
"telephone_number": "207-774-5761",
"fax_number": "207-874-7478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEROACK",
"first_name": "BRIAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2008-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ME",
"license": "013245",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0673610001",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "269530099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RAILROAD MEDICARE",
"identifier": "660000685",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.