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MARY ELSA THEOBALD NP
NPI 1356418685
Nurse Practitioner in Brooks, ME

Active since November 30, 2006PECOS Enrolled
98.06/100
CMS Quality Rating
55 REYNOLDS ROAD, BROOKS, ME 04915(207) 722-3488(207) 722-3183 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary Elsa Theobald Np NPPES

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

MARY ELSA THEOBALD NP (NPI 1356418685) is an individual nurse practitioner in Brooks, Maine, licensed in Maine (R030807) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356418685
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMARY ELSA THEOBALDCredential: NP
Location Address55 REYNOLDS ROADBrooks, ME 04915
Mailing AddressPo Box 159Brooks, ME 04921-0159 · (207) 722-3488 · Fax (207) 722-3183
Phone(207) 722-3488
Fax(207) 722-3183
Sole ProprietorNo
Enumeration DateNovember 30, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1356418685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in ME · R030807
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
55 REYNOLDS ROAD, Brooks, ME 04915
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINP23039ME

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Elsa Theobald Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Theobald reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mainehealth
11 mi
Critical Access
118 NORTHPORT AVE
Belfast, ME 04915
  • Reassigned Medicare billing, Maine enrollment
  • Also billed through NPI 1265912075 (Maine)
  • 211 clinicians in this Medicare group
NPI 1841397932 (207) 338-2500
Mainehealth
11 mi
Critical Access
118 NORTHPORT AVE
Belfast, ME 04915
  • Reassigned Medicare billing, Maine enrollment
  • Medicare enrollment name: Waldo County General Hospital
  • 82 clinicians in this Medicare group
NPI 1841397932 (207) 338-2500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04915 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
$82.58 typical visit price
range $53.26 – $162.77
Typical copayment $20.64 (range $13.31 – $40.69)
Most-billed visit code 99203
Established Patient
$94.60 typical visit price
range $16.90 – $132.79
Typical copayment $23.65 (range $4.22 – $33.19)
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.

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

Referred Medical Equipment & Supplies CMS DME claims 2

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

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers11 claims11 services$33.26 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers26 claims26 services$199.51 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

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

JOHN J PAGONIS MD
Family Medicine
55 REYNOLDS ROAD
BROOKS, ME 04915
Waldo County (207) 722-3488

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 Mary Theobald's NPI number?

The NPI number for Mary Theobald is 1356418685. It was assigned to this individual provider in the NPPES registry on November 30, 2006.

Where is Mary Theobald located?

Mary Theobald practices at 55 Reynolds Road, Brooks, ME 04915. The listed phone number is (207) 722-3488.

What is Mary Theobald's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mary Theobald enrolled in Medicare?

Yes. Mary Theobald is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Theobald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Theobald reassigns Medicare benefits to 2 organizations: Mainehealth (Belfast, ME) and Mainehealth (Belfast, ME). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Theobald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Theobald was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.