CATHERINE P SEXTON FNP
NPI 1538447339
Nurse Practitioner - Family in Scarborough, ME

Active since July 27, 2011PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
175 US ROUTE 1, SCARBOROUGH, ME 04074(207) 396-7700 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2025, Apr 9, 2018, Jul 24, 2017 (3 updates tracked since 2017).

About Catherine P Sexton Fnp NPPES

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

CATHERINE P SEXTON FNP (NPI 1538447339) is an individual family provider in Scarborough, Maine, licensed in Maine (CNP111055) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1538447339
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCATHERINE P SEXTONCredential: FNP
Location Address175 US ROUTE 1Scarborough, ME 04074-9048
Mailing Address175 Us Route 1Scarborough, ME 04074-9048 · (207) 396-7700
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 27, 2011
Last NPPES UpdateApril 17, 20253 updates tracked since enumeration
NPPES CertifiedApril 17, 2025
NPI 1538447339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses Licensed in ME · CNP111055 Licensed in NH · 114001-23
175 US ROUTE 1, Scarborough, ME 04074

Secondary Practice Locations 2

Location 1108 Centre St Ste 100Bath, ME 04530-2550 · Phone (207) 386-1990 · Fax (207) 618-5675
Location 23073 White Mountain HwyNorth Conway, NH 03860-7101 · Phone (603) 356-0796 · Fax (603) 356-3257

Other Identifiers 1

Other002327504ME · Medicare

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

Catherine P Sexton Fnp 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 ID3678744075
PECOS Enrollment IDI20110915000174
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 4

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.
331 services156 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
221 services100 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.
29 services25 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
22 services17 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

Maine General Medical Center

Acute Care Hospitals · Augusta, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number200039
Location35 Medical Center ParkwayAugusta, ME 04330 · Kennebec 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
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.

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 8

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
8 suppliers49 claims619 services$19.00 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
9 suppliers54 claims1,745 services$2.42 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
34 suppliers78 claims408 services$6.17 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
16 suppliers30 claims71 services$1.05 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers25 claims25 services$284.26 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
13 suppliers37 claims4,360 services$6.84 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.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
175 US ROUTE 1
SCARBOROUGH, ME 04074
Internal Medicine
175 US ROUTE 1
SCARBOROUGH, ME 04074
Dietitian, Registered
175 US ROUTE 1
SCARBOROUGH, ME 04074
Internal Medicine (Endocrinology, Diabetes & Metabolism)
175 US ROUTE 1
SCARBOROUGH, ME 04074
Dietitian, Registered
175 US ROUTE 1
SCARBOROUGH, ME 04074
Nurse Practitioner (Family)
175 US ROUTE 1
SCARBOROUGH, ME 04074
Nurse Practitioner (Acute Care)
175 US ROUTE 1
SCARBOROUGH, ME 04074
Dietitian, Registered
175 US ROUTE 1
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 Catherine Sexton's NPI number?

The NPI number for Catherine Sexton is 1538447339. It was assigned to this individual provider in the NPPES registry on July 27, 2011.

Where is Catherine Sexton located?

Catherine Sexton practices at 175 Us Route 1, Scarborough, ME 04074. The listed phone number is (207) 396-7700.

What is Catherine Sexton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Catherine Sexton enrolled in Medicare?

Yes. Catherine Sexton 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 Catherine Sexton accept?

Health plans from Anthem Blue Cross and Blue Shield list Catherine Sexton 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 Catherine Sexton affiliated with any hospitals?

According to CMS data, Catherine Sexton is affiliated with Maine Medical Center, Maine General Medical Center and Penobscot Bay Medical Center.

When was this NPI record last updated?

The NPPES record for Catherine Sexton was last updated on April 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.