JOHN NOONAN JR. PA-C
NPI 1164806527
Physician Assistant - Surgical in Portland, ME
About John Noonan Jr. Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN NOONAN JR. PA-C (NPI 1164806527) is an individual surgical provider in Portland, Maine, licensed in Maine (PA1545) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John Noonan Jr. Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
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.
PORTLAND, ME 04102
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 Noonan's NPI number?
The NPI number for John Noonan is 1164806527. It was assigned to this individual provider in the NPPES registry on July 16, 2015.
Where is John Noonan located?
John Noonan practices at 33 Sewall St, Portland, ME 04102. The listed phone number is (207) 828-2100.
What is John Noonan's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is John Noonan enrolled in Medicare?
Yes. John Noonan is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for John Noonan was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.
# John Noonan Jr., PA-C · NPI 1164806527
Surgical physician in Portland, Maine. Individual provider, active in the CMS NPPES registry since July 16, 2015.
## Identity
- **NPI:** 1164806527 (Entity type: Individual)
- **Enumerated:** July 16, 2015
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** PA1545 (Maine)
- **Sole proprietor:** No
## Practice location
- **Address:** 33 SEWALL ST, Portland, ME 04102-2603
- **Phone:** (207) 828-2100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1164806527) · Data from the CMS NPPES public registry.