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DR. DOUGLAS COUPER MD
NPI 1154371243
Internal Medicine in Portland, ME

Active since May 11, 2006PECOS EnrolledAccepts Medicare Assignment
331 VERANDA ST, PORTLAND, ME 04103(207) 791-3796(207) 828-2429 Get Directions Write a Review

NPPES record last updated: September 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Douglas Couper Md NPPES

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

DR. DOUGLAS COUPER MD (NPI 1154371243) is an individual internal medicine provider in Portland, Maine, licensed in Maine (MD13320) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Boston University School Of Medicine (1987).

NPPES Registry Identity

NPI1154371243
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. DOUGLAS COUPERCredential: MD
Location Address331 VERANDA STPortland, ME 04103-5545
Mailing AddressPo Box 9746Portland, ME 04104-5040 · (207) 791-3888 · Fax (207) 828-7850
Phone(207) 791-3796
Fax(207) 828-2429
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 1987
Enumeration DateMay 11, 2006
Last NPPES UpdateSeptember 29, 2020
NPPES CertifiedSeptember 29, 2020
✔ NPI 1154371243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in ME · MD13320
Definition
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.
331 VERANDA ST, Portland, ME 04103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Dr. Douglas Couper Md 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 ID7810933033
PECOS Enrollment IDI20050628001047
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 6

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 moderate level of decision making, if using time, 30 minutes or more 99214
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.
73 services66 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
36 services33 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
16 services16 patients
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.
14 services14 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
14 services14 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04103 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
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
Most-billed visit code 99214
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
85%755 patients5/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
61%170 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%8,016 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
54%1,424 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%535 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
72%1,515 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
22%1,463 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
99%1,515 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
59%1,515 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
59%1,515 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers11 claims35 services$6.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LINDA K MORRISON MD
Ophthalmology
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
MR. DAVID GHIORSE PA-C
Physician Assistant
331 VERANDA ST, MARTINS POINT HEALTH CARE
PORTLAND, ME 04103
Cumberland County (207) 828-2402
CARLEEN KNIGHT NP
Nurse Practitioner
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
JOSHUA GELFAND DPT
Physical Therapist
331 VERANDA ST, BUILDING 6, ROOM 3311
PORTLAND, ME 04103
Cumberland County (207) 536-0702
JAMES MCILHENNY RIDDLEBERGER M.D.
Family Medicine
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
GEORGE NICHOLAS WELCH MD
Internal Medicine (Cardiovascular Disease)
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
DR. WILLIAM R WADLAND MD
Family Medicine (Geriatric Medicine)
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 828-2402
DR. WILLIAM SCHIRMER MD
Family Medicine
331 VERANDA ST
PORTLAND, ME 04103
Cumberland County (207) 791-3782

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 Douglas Couper's NPI number?

The NPI number for Douglas Couper is 1154371243. It was assigned to this individual provider in the NPPES registry on May 11, 2006.

Where is Douglas Couper located?

Douglas Couper practices at 331 Veranda St, Portland, ME 04103. The listed phone number is (207) 791-3796.

What is Douglas Couper's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Douglas Couper enrolled in Medicare?

Yes. Douglas Couper 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 Douglas Couper accept?

Health plans from Anthem Blue Cross and Blue Shield list Douglas Couper 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.

When was this NPI record last updated?

The NPPES record for Douglas Couper was last updated on September 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.