Individual provider Active NPI

Carl R Cutshall, PA

  • Medical Physician Assistant
  • Bangor, ME
National Provider Identifier
1932280559
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA337 Issued in ME
Practice address
153 Maple St
Bangor, ME 04401-4031
Phone
(207) 942-8790
NPI assigned
Oct 18, 2006
Last updated
Jan 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA337 ME Primary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X ME337 ME

Addresses

Primary practice location

153 Maple St
Bangor, ME 04401-4031

Mailing address

153 Maple St
Bangor, ME 04401-4031
Phone (207) 942-8790

Other practice location 1

119 Northport Ave Fl 1
Belfast, ME 04915-6069
Phone (207) 505-4567

Other practice location 2

24 Miles Center Way
Damariscotta, ME 04543-4067
Phone (207) 563-4250

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040802000587 ME Practitioner - Physician Assistant 2062483449 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

24 Miles Ctr Way
Maine Behavioral Healthcare
Damariscotta, ME 04543-4067
Phone (844) 292-0111

5 Miles Ctr Way
Damariscotta, ME 04543-4067
Phone (207) 563-3782

Hospital & facility affiliations

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
ME337MEMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Jan 5, 2004 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients
Richard J Mazzei MD PA PastSince Jul 1, 2008 Accepting new patients

Locations

116 Northport Ave
Ste 220
Belfast, ME 04915
Phone (207) 505-4015

119 Northport Ave
Fl 1
Belfast, ME 04915
Phone (207) 505-4567

24 Miles Center Way
Damariscotta, ME 04543
Phone (207) 563-4250

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • Direct secure messaging: ccutshall182207@direct.mmc.mainehealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1932280559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 MAPLE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014031",
            "telephone_number": "207-942-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MAPLE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014031",
            "telephone_number": "207-942-8790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Northport Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156069",
            "country_code": "US",
            "telephone_number": "207-505-4567",
            "fax_number": "207-536-2794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Miles Center Way",
            "address_purpose": "LOCATION",
            "city": "Damariscotta",
            "state": "ME",
            "postal_code": "045434067",
            "country_code": "US",
            "telephone_number": "207-563-4250",
            "fax_number": "207-810-4977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUTSHALL",
        "first_name": "CARL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA337",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "ME",
            "license": "ME337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.