NPIMap

Individual provider Active NPI

Jesse D Sammon, D.O.

  • Urology Physician
  • South Portland, ME
National Provider Identifier
1962639062
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DO2589 Issued in ME
Practice address
100 Brickhill Ave
South Portland, ME 04106-1999
Phone
(207) 773-1728
Fax
(207) 773-8153
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X DO2589 ME Primary

Addresses

Primary practice location

100 Brickhill Ave
South Portland, ME 04106-1999

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

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
I20160919001550 ME Practitioner - Urology 5395977201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of New England, College of Osteo Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

100 Brickhill Ave
South Portland, ME 04106-1999
Phone (207) 775-1255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.43 of 100Reported as group
Quality
8.29
Promoting interoperability
100
Improvement activities
0
Cost
66.46

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
Prostate resection11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Maine Medical Partners CurrentSince Jul 1, 2016 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Jul 1, 2016 Accepting new patients
Maine Medical Partners Urology CurrentSince Jul 1, 2016 Accepting new patients
Mainehealth CurrentSince Jul 1, 2016 Accepting new patients

Locations

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

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

100 Brickhill Ave
South Portland, ME 04106
Phone (207) 773-1728

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

Interoperability endpoints

  • Direct secure messaging: jsammon140841@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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1962639062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRICKHILL AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061999",
            "telephone_number": "207-773-1728",
            "fax_number": "207-773-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMON",
        "first_name": "JESSE",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ME",
            "license": "DO2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.