ROBERT P SMITH JR. MD
NPI 1750340972
Internal Medicine - Infectious Disease in South Portland, ME


Quality Rating: 98.23 out of 100 score

NPI Status: Active since March 18, 2006

Contact Information

50 FODEN RD, STE 3
SOUTH PORTLAND, ME
ZIP 04106
Phone: (207) 774-5816
Fax: (207) 523-8594

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  • Individual
  • Male
  • Internal Medicine
  • Infectious Disease
  • Accepts Insurance
  • PECOS Enrolled

About ROBERT SMITH

This page provides the complete NPI Profile along with additional information for Robert Smith, an internist established in South Portland, Maine with a medical specialization in Internal Medicine, focusing in infectious disease . The healthcare provider is registered in the NPI registry with number 1750340972 assigned on March 2006. The practitioner's primary taxonomy code is 207RI0200X with license number MD12397 (ME). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1750340972
Provider Name
ROBERT P SMITH JR. MD
Gender
Male
Entity Type
Individual
Location Address
50 FODEN RD, STE 3 SOUTH PORTLAND, ME 04106
Location Phone
(207) 774-5816
Location Fax
(207) 523-8594
Mailing Address
100 GANNETT DRIVE SUITE C SOUTH PORTLAND, ME 04106
Mailing Phone
(207) 523-3649
Mailing Fax
(207) 523-8594
Is Sole Proprietor?
No
Enumeration Date
03-18-2006
Last Update Date
01-31-2019
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An internist like Robert Smith 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 Infectious Disease

Taxonomy Code
207RI0200X
Type
Allopathic & Osteopathic Physicians
License No.
MD12397
License State
ME
Taxonomy Description
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

MD12397 (ME)

Insurance Plans Accepted

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

  • 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
238250099MEDICAID (05)ME 
1040616OTHER (01)AETNA
010550OTHER (01)ANTHEM

Medicare Participation & PECOS Enrollment Status

Robert Smith 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

  • 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

Physician Visit Costs

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 04106 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.
1750340972
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27100640914
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 6 + 4 + 0 + 9 + 1 + 4 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1750340972 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1326009259 PATRICIA B STOGSDILL MD
Individual
Internal Medicine (Infectious Disease)50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 774-5816
1093884710DR. EMILY V WOOD MD
Individual
Internal Medicine (Infectious Disease)50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 774-5816
1487871414 LEYLA AZIS MD
Individual
Internal Medicine (Infectious Disease)50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 774-5816
1396905048 KINNA THAKARAR DO
Individual
Internal Medicine (Infectious Disease)50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 774-5816
1073579074 LAUREEN A BICZAK DO
Individual
Internal Medicine50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 774-5816
1750354775 MICHELE LABOTZ MD
Individual
Pediatrics50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 523-8500
1619054053 ERIC S. SAMPSON MD
Individual
Emergency Medicine50 FODEN RD, STE 3
SOUTH PORTLAND, ME 04106
(207) 523-3700

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750340972, enumerated in the NPI registry as an "individual" on March 18, 2006

The provider is located at 50 Foden Rd, Ste 3 South Portland, Me 04106 and the phone number is (207) 774-5816

The provider's speciality is Internal Medicine with taxonomy code 207RI0200X with a focus in Infectious Disease

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Harvard Pilgrim. 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.

This NPI record was last updated on March 18, 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].
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