Individual provider Active NPI

John B Thaller, MD

  • Orthopaedic Hand Surgery Physician
  • Augusta, ME
National Provider Identifier
1922047505
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD17126 Issued in ME
Practice address
15 Enterprise Dr
Ste 100
Augusta, ME 04330-7894
Phone
(207) 621-8700
Fax
(207) 621-8701
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 017126 ME
Orthopaedic Hand Surgery Physician 207XS0106X MD17126 ME Primary

Addresses

Primary practice location

15 Enterprise Dr
Ste 100
Augusta, ME 04330-7894

Mailing address

15 Enterprise Dr
Ste 100
Augusta, ME 04330-7894
Phone (207) 621-8700

Other identifiers 1

IdentifierTypeStateIssuer
432326199MedicaidME

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
I20060823000037 ME Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 7214930759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

107 1St Park Dr
Oakland, ME 04963-5367
Phone (207) 453-3000

149 N St
Waterville, ME 04901
Phone (207) 872-1000

15 Enterprise Dr
Mainegeneral Express Care
Augusta, ME 04330-7997
Phone (207) 621-8880

Hospital & facility affiliations

  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017126MEMDOrthopaedic Surgery Physician
MD17126MEMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Nov 1, 2013 Accepting new patients
Mainegeneral Medical Center CurrentSince Nov 1, 2013 Accepting new patients
Mainegeneral Medical Center Orthopaedic Surgery Past Accepting new patients

Locations

11 Caldwell Rd
Augusta, ME 04330
Phone (207) 623-7710

15 Enterprise Dr
Augusta, ME 04330
Phone (207) 621-7500

15 Enterprise Dr
Ste 100
Augusta, ME 04330
Phone (207) 621-7500

150 Dresden Ave
Gardiner, ME 04345
Phone (207) 621-9337

107 First Park Dr
Oakland, ME 04963
Phone (207) 621-8700

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: johnthaller@mgh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1922047505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "address_2": "STE 100",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307894",
            "telephone_number": "207-621-8700",
            "fax_number": "207-621-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENTERPRISE DR",
            "address_2": "STE 100",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307894",
            "telephone_number": "207-621-8700",
            "fax_number": "207-621-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALLER",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "017126",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "ME",
            "license": "MD17126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432326199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.