NPIMap

Individual provider Active NPI

Matthew Lee Stephenson, MD

  • Diagnostic Radiology Physician
  • Portland, ME
National Provider Identifier
1972800282
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD22755 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-0111
NPI assigned
Feb 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME111863 FL
Diagnostic Radiology Physician 2085R0202X 30036 SC
Diagnostic Radiology Physician 2085R0202X 49955 TN
Diagnostic Radiology Physician 2085R0202X MD22755 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

324 Gannett Dr Ste 200
South Portland, ME 04106-3266
Phone (207) 482-7800

Other identifiers 3

IdentifierTypeStateIssuer
Q001107MedicaidTN
005948100MedicaidFL
P01237985OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190516001731 ME Practitioner - Diagnostic Radiology 7719152750 Reassigns benefits to 4 organizations
I20190626000997 NH Practitioner - Diagnostic Radiology 7719152750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Healthcare Partners PAGroup PAC ID 7618871245, shared by 7 NPIs, 305 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 871-2571

3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone (603) 356-5461

33 Sewall St
Portland, ME 04102-2603
Phone (207) 828-2160

600 Turner St
Suite 1
Auburn, ME 04210-5093
Phone (207) 601-3333

Hospital & facility affiliations

  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009
  • Memorial Hospital, the Hospital, North Conway, NH, CCN 301307
  • St Mary'S Regional Medical Center Hospital, Lewiston, ME, CCN 200034
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD22755MEMDDiagnostic Radiology Physician
30036SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Healthcare Partners, P.a CurrentSince Dec 28, 2021 Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Jun 1, 2019 Accepting new patients
Insight-Premier Health LLC Diagnostic Radiology CurrentSince May 29, 2019 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology Current Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince Jun 1, 2019 Accepting new patients
Spectrum Healthcare Partners, P.a Diagnostic Radiology CurrentSince Feb 1, 2021 Accepting new patients
Spring Hill Imaging Center LLC PastSince Sep 5, 2006 Accepting new patients

Locations

600 Turner St
Ste 1
Auburn, ME 04210
Phone (207) 601-3333

84 Marginal Way
Portland, ME 04101
Phone (207) 774-5816

33 Sewall St
Portland, ME 04102
Phone (207) 772-0076

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

324 Gannett Dr
Ste 200
South Portland, ME 04106
Phone (207) 482-7861

3073 White Mountain Hwy
North Conway, NH 03860
Phone (603) 356-5472

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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1972800282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800",
            "fax_number": "207-956-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME111863",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "30036",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "49955",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD22755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q001107",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005948100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01237985",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.