Individual provider Active NPI

Timothy C O'Brien, M.D.

  • Surgery Physician
  • Rockport, ME
National Provider Identifier
1962441055
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD18627 Issued in ME
Practice address
4 Glen Cove Dr
Suite 103
Rockport, ME 04856-4235
Phone
(207) 593-5737
Fax
(207) 593-5333
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD18627 ME Primary

Addresses

Primary practice location

4 Glen Cove Dr
Suite 103
Rockport, ME 04856-4235

Mailing address

4 Glen Cove Dr
Suite 103
Rockport, ME 04856-4235
Phone (207) 593-5737

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
I20101104001438 ME Practitioner - General Surgery 1557555364 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Hahnemann University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

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

4 Glen Cove Dr
Rockport, ME 04856-4236

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 921-8969

Hospital & facility affiliations

  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063

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
Colonoscopy1-10
Hernia repair - groin (open)12
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Penobscot Bay Physicians & Associates CurrentSince Oct 1, 2012 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Past Accepting new patients
Mainegeneral Medical Center Surgery Past Accepting new patients

Locations

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

3 Glen Cove Dr
#3
Rockport, ME 04856
Phone (207) 301-5400

4 Glen Cove Dr
Ste 5
Rockport, ME 04856
Phone (207) 592-5883

4 Glen Cove Dr
Ste 103
Rockport, ME 04856
Phone (207) 301-5737

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

Interoperability endpoints

  • Direct secure messaging: tobrien18108@direct.mmc.mainehealth.org

Organizations & group practices 7

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 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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1962441055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GLEN COVE DR",
            "address_2": "SUITE 103",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564235",
            "telephone_number": "207-593-5737",
            "fax_number": "207-593-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GLEN COVE DR",
            "address_2": "SUITE 103",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564235",
            "telephone_number": "207-593-5737",
            "fax_number": "207-593-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD18627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.