NPIMap

Individual provider Active NPI

Matthew T. Johnson, PA-C

  • Surgical Physician Assistant
  • Scarborough, ME
National Provider Identifier
1972547404
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-703 Issued in ME
Practice address
92 Campus Dr
Scarborough, ME 04074-7228
Phone
(207) 885-0011
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA-703 ME Primary

Addresses

Primary practice location

92 Campus Dr
Scarborough, ME 04074-7228

Mailing address

92 Campus Dr
Scarborough, ME 04074-7228
Phone (207) 885-0011

Other practice location 1

118 Northport Ave
Belfast, ME 04915-6009
Phone (207) 338-2500

Other identifiers 2

IdentifierTypeStateIssuer
241390099MedicaidME
30336259MedicaidNH

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
I20070905000426 ME Practitioner - Physician Assistant 3274626338 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
York HospitalGroup PAC ID 6406766781, 202 clinicians
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

15 Hospital Dr
York, ME 03909-1011
Phone (207) 363-4321

16 Hospital Dr
York, ME 03909-1011
Phone (207) 351-3715

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

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • York Hospital Hospital, York, ME, CCN 200020
  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039

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
PA-703MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Jul 30, 2012 Accepting new patients
Mainehealth CurrentSince Feb 17, 2009 Accepting new patients
Maine Medical Partners CurrentSince Dec 9, 2010 Accepting new patients
Mainehealth CurrentSince Feb 17, 2009 Accepting new patients
Mainehealth CurrentSince Jul 5, 2025 Accepting new patients
Maine Medical Partners Surgical CurrentSince Dec 9, 2010 Accepting new patients
Mercy Hospital CurrentSince Jul 30, 2012 Accepting new patients
Mainehealth Past Accepting new patients
Spectrum Healthcare Partners, P.a. PastSince Sep 10, 2023 Accepting new patients

Locations

118 Northport Ave
Belfast, ME 04915
Phone (207) 338-9345

195 Fore River Pkwy
Ste 490
Portland, ME 04102
Phone (207) 553-6054

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

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

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

92 Campus Dr
Scarborough, ME 04074
Phone (207) 797-5753

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

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

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

Interoperability endpoints

  • Direct secure messaging: mjohnson5489@direct.mmc.mainehealth.org

Organizations & group practices 12

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1972547404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747228",
            "telephone_number": "207-885-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747228",
            "telephone_number": "207-885-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Northport Ave",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156009",
            "country_code": "US",
            "telephone_number": "207-338-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA-703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241390099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30336259",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.