JOHN BIRKNES M.D.
NPI 1134329402
Neurological Surgery in Scarborough, ME

Active since July 24, 2007PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
49 SPRING ST, SCARBOROUGH, ME 04074(207) 885-0011 Get Directions Write a Review

NPPES record last updated: May 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About John Birknes M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN BIRKNES M.D. (NPI 1134329402) is an individual neurological surgery provider in Scarborough, Maine, licensed in Virginia (0101244138) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2001).

NPPES Registry Identity

NPI1134329402
Entity TypeIndividualMale
Primary Taxonomy207T00000X
Provider Legal NameJOHN BIRKNESCredential: M.D.
Location Address49 SPRING STScarborough, ME 04074-8926
Mailing Address49 Spring StScarborough, ME 04074-8926 · (207) 885-0011
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2001
Enumeration DateJuly 24, 2007
Last NPPES UpdateMay 28, 2020
NPPES CertifiedMay 28, 2020
NPI 1134329402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Licenses Licensed in VA · 0101244138 Licensed in ME · MD23462
Definition
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Also ListedSurgery · Pediatric SurgeryTaxonomy 2086S0120X · License 0101244138 (VA), MD422479 (PA)
49 SPRING ST, Scarborough, ME 04074

Other Identifiers 8

Other1134329402VA · Mamsi/optimum Choice
Other1134329402VA · Mdipa
Medicaid5910591NC
Other1134329402VA · Aetna
Other364137VA · Anthem Bc/bs
Other1134329402VA · Optima Health Care
Medicaid1134329402VA
Other1134329402VA · Cigna

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

John Birknes M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375691447
PECOS Enrollment IDI20200514002628
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services13 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Mid Coast Hospital

Acute Care Hospitals · Brunswick, ME
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200021
Location123 Medical Center DriveBrunswick, ME 04011 · Cumberland County
Emergency services Birthing friendly

Penobscot Bay Medical Center

Acute Care Hospitals · Rockport, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200063
Location6 Glen Cove DriveRockport, ME 04856 · Knox County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$128.83 typical visit price
range $56.28 – $169.96
Typical copayment $32.20 (range $14.07 – $42.49)
Most-billed visit code 99204
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.13
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Pediatrics)
49 SPRING ST
SCARBOROUGH, ME 04074
Physical Therapist
49 SPRING ST, 1ST FLOOR
SCARBOROUGH, ME 04074
Neurological Surgery
49 SPRING ST, 1ST FLOOR
SCARBOROUGH, ME 04074
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
49 SPRING ST
SCARBOROUGH, ME 04074
Physical Medicine & Rehabilitation
49 SPRING ST
SCARBOROUGH, ME 04074
Physician Assistant (Surgical)
49 SPRING ST, 1ST FLOOR
SCARBOROUGH, ME 04074
Neurological Surgery
49 SPRING ST, 1ST FLOOR
SCARBOROUGH, ME 04074
Neurological Surgery
49 SPRING ST, 1ST FLOOR
SCARBOROUGH, ME 04074

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Birknes's NPI number?

The NPI number for John Birknes is 1134329402. It was assigned to this individual provider in the NPPES registry on July 24, 2007.

Where is John Birknes located?

John Birknes practices at 49 Spring St, Scarborough, ME 04074. The listed phone number is (207) 885-0011.

What is John Birknes's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Is John Birknes enrolled in Medicare?

Yes. John Birknes is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Birknes accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list John Birknes as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is John Birknes affiliated with any hospitals?

According to CMS data, John Birknes is affiliated with Maine Medical Center, Mid Coast Hospital and Penobscot Bay Medical Center.

When was this NPI record last updated?

The NPPES record for John Birknes was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.