NPIMap

Individual provider Active NPI

Kristy M Surprise, ANP

  • Adult Health Nurse Practitioner
  • Biddeford, ME
National Provider Identifier
1952559908
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP81940 Issued in ME
Practice address
One Medical Center Drive
Biddeford, ME 04005
Phone
(207) 283-7000
Fax
(207) 283-7275
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP81940 ME
Adult Health Nurse Practitioner 363LA2200X CNP81940 ME Primary

Addresses

Primary practice location

One Medical Center Drive
Biddeford, ME 04005

Mailing address

One Medical Center Drive
Biddeford, ME 04005
Phone (207) 283-7000

Other identifiers 2

IdentifierTypeStateIssuer
30347565MedicaidNH
433351099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000307 ME Practitioner - Nurse Practitioner 0547329732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince May 6, 2013 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince May 6, 2013 Accepting new patients
Maine Center for Lipids & Cardiovascular Health LLC Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

335 Brighton Ave
Portland, ME 04102
Phone (207) 662-8000

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

887 Congress St
Ste 200
Portland, ME 04102
Phone (207) 771-5549

96 Campus Dr
Ste 1
Scarborough, ME 04074
Phone (207) 396-5611

96 Campus Dr
Ste 2A
Scarborough, ME 04074
Phone (207) 885-8775

175 US Route 1
Scarborough, ME 04074
Phone (207) 396-7700

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: ksurprise160574@direct.mmc.mainehealth.org

Organizations & group practices 6

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 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1952559908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "04005",
            "telephone_number": "207-283-7000",
            "fax_number": "207-283-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "04005",
            "telephone_number": "207-283-7000",
            "fax_number": "207-283-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPRISE",
        "first_name": "KRISTY",
        "middle_name": "M",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP81940",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP81940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30347565",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433351099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.