JOHN E ERICKSON MD
NPI 1043289713
Internal Medicine in Portland, ME


Quality Rating: 98.23 out of 100 score

NPI Status: Active since March 16, 2006

Contact Information

84 MARGINAL WAY
SUITE 700
PORTLAND, ME
ZIP 04101
Phone: (207) 774-5816
Fax: (207) 523-8597

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  • Individual
  • Male
  • Years of Experience 46
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOHN ERICKSON

This page provides the complete NPI Profile along with additional information for John Erickson, an internist established in Portland, Maine with a medical specialization in Internal Medicine and more than 46 years of experience. He graduated from George Washington University School Of Medicine in 1980. The healthcare provider is registered in the NPI registry with number 1043289713 assigned on March 2006. The practitioner's primary taxonomy code is 207R00000X with license number 012994 (ME). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1043289713
Provider Name
JOHN E ERICKSON MD
Gender
Male
Entity Type
Individual
Location Address
84 MARGINAL WAY SUITE 700 PORTLAND, ME 04101
Location Phone
(207) 774-5816
Location Fax
(207) 523-8597
Mailing Address
100 FODEN RD SUITE 203 SOUTH PORTLAND, ME 04106
Mailing Phone
(207) 828-0361
Mailing Fax
(207) 523-8597
Medical School Name
GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1980
Is Sole Proprietor?
No
Enumeration Date
03-16-2006
Last Update Date
10-08-2010
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An internist like John Erickson is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
012994
License State
ME
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
  • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
  • Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
  • Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
  • Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
  • NH Local Choice HMO Bronze 8000 - HMO
  • NH Local Choice HMO Gold - HMO
  • NH Local Choice HMO Gold 1400 - HMO
  • NH Local Choice HMO HSA Bronze 6000 - HMO
  • NH Local Choice HMO Silver 3500 - HMO
  • NH Local Choice HMO Silver 5000 - HMO
  • NH Local HMO Bronze 7500 Standard - HMO
  • NH Local HMO Gold 1500 Standard - HMO
  • NH Local HMO Silver 5000 Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
270190099MEDICAID (05)ME 
010560OTHER (01)ANTHEM
MM3120MEDICARE ID-TYPE UNSPECIFIED (04) 
MM312001MEDICARE PIN (08) 
1041229OTHER (01)AETNA
CX4557MEDICARE PIN (08)ME 
B81955MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

John Erickson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

John Erickson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7012951700

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050614000448

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Unknown

  • Other-Enteral and Parenteral (OB006N)

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4035)

    1 DME suppliers used 13 Medicare Claims 403 Services Paid

  • Other-Enteral and Parenteral (OB006N)

    Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4150)

    1 DME suppliers used 12 Medicare Claims 4236 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 25 times for 23 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.2 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 04101 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $128.83
  • Minimum New Patient Price $56.28
  • Maximum New Patient Price $169.96
  • Average New Patient Copayment $32.2
  • Minimum New Patient Copayment $14.07
  • Maximum New Patient Copayment $42.49

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.18
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $138.92
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $34.73

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 98.23, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 98.23 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 86.46

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1043289713
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2083481872
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 8 + 3 + 4 + 8 + 1 + 8 + 7 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1043289713 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1114996808MS. MICHELLE BELYEA PNP
Individual
Nurse Practitioner84 MARGINAL WAY SUITE 1000
PORTLAND, ME 04101
(207) 774-4092
1982673638MS. LORRAINE LALIBERTE PAC
Individual
Physician Assistant84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816
1326017070MS. LOIS TIEDEKEN ANP
Individual
Nurse Practitioner84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
(207) 774-5816
1508835265 AUGUST JOHN VALENTI MD
Individual
Internal Medicine (Infectious Disease)84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
(207) 774-5816
1598734253 DAVID W LYNCH MD
Individual
Pediatrics84 MARGINAL WAY SUITE 1000
PORTLAND, ME 04101
(207) 774-4092
1043289705 CAROL M VAUGHAN MD
Individual
Obstetrics & Gynecology84 MARGINAL WAY SUITE 900
PORTLAND, ME 04101
(207) 874-2445
1679542336 EMIL C GOTSCHLICH MD
Individual
Obstetrics & Gynecology84 MARGINAL WAY SUITE 900
PORTLAND, ME 04101
(207) 874-2445
1194794859 JAMES H ZEITLIN MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816
1972572758 CAROLINE M HODSDON MD
Individual
Obstetrics & Gynecology84 MARGINAL WAY SUITE 900
PORTLAND, ME 04101
(207) 874-2445
1821067521 PAUL D RITGER MD
Individual
Pediatrics84 MARGINAL WAY SUITE 1000
PORTLAND, ME 04101
(207) 774-4092
1750350492 NINA S TROWBRIDGE MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816
1487623120 CHARLOTTE A KASSAB MD
Individual
Obstetrics & Gynecology84 MARGINAL WAY SUITE 900
PORTLAND, ME 04101
(207) 874-2445
1861461535 CHARLES J CATHCART MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816
1942279617 STEVEN T DOBIESKI MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
(207) 774-5816
1891764577 JOEL L BOTLER MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816
1487623153 THOMAS F CLAFFEY MD
Individual
Internal Medicine84 MARGINAL WAY STE 800
PORTLAND, ME 04101
(207) 774-5816
1295704971 WENDY S CATHCART MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
(207) 774-5816
1922077601 TIMOTHY C BAUM MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 800
PORTLAND, ME 04101
(207) 774-5816
1063471225 JAMES C FOSTER MD
Individual
Pediatrics84 MARGINAL WAY SUITE 1000
PORTLAND, ME 04101
(207) 774-4092
1316906589 DANIEL L LOISELLE MD
Individual
Internal Medicine84 MARGINAL WAY SUITE 700
PORTLAND, ME 04101
(207) 774-5816

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043289713, enumerated in the NPI registry as an "individual" on March 16, 2006

The provider is located at 84 Marginal Way Suite 700 Portland, Me 04101 and the phone number is (207) 774-5816

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 46 years of experience. He graduated from George Washington University School Of Medicine in 1980.

The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $128.83 with an average copayment of $32.2 for new patient appointments. Established patients should expect a typical charge of $99.18 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 30-39 minutes.

This NPI record was last updated on March 16, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.