STEPHAN P BABIRAK MD
NPI 1689619884
Internal Medicine - Endocrinology, Diabetes & Metabolism in Scarborough, ME

Active since June 19, 2006PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
71 US ROUTE 1 STE J, SCARBOROUGH, ME 04074(207) 396-6433(207) 396-6436 Get Directions Write a Review

NPPES record last updated: March 26, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stephan P Babirak Md NPPES

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

STEPHAN P BABIRAK MD (NPI 1689619884) is an individual endocrinology, diabetes & metabolism provider in Scarborough, Maine, licensed in Maine (014625) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (1983).

NPPES Registry Identity

NPI1689619884
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameSTEPHAN P BABIRAKCredential: MD
Location Address71 US ROUTE 1 STE JScarborough, ME 04074-7168
Mailing Address71 Us Route 1 Ste JScarborough, ME 04074-7168 · (207) 396-6433 · Fax (207) 396-6436
Fax(207) 396-6436
Sole ProprietorNo
Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 1983
Enumeration DateJune 19, 2006
Last NPPES UpdateMarch 26, 2013
NPI 1689619884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in ME · 014625
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 014625 (ME)
71 US ROUTE 1 STE J, Scarborough, ME 04074

Other Identifiers 6

Medicare PIN460002367ME
Medicare PINMM6988ME
Medicaid30200760NH
Medicare PINMX2683ME
Medicaid322050099ME
Medicare UPINF27957

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

Stephan P Babirak 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 ID8729022355
PECOS Enrollment IDI20050615000200
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.

Mechanical separation of plasma and abnormal antibodies from blood 36516
This procedure involves separating plasma, the liquid part of your blood, and any abnormal antibodies from the rest of your blood. It's done to remove harmful substances and improve your health. Afterwards, your blood, minus the plasma and abnormal antibodies, is returned to your body.
253 services13 patients
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.
177 services137 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
141 services80 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.
87 services84 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.
64 services34 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.
42 services35 patients

Hospital Affiliations CMS Care Compare 5

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

York Hospital

Acute Care Hospitals · York, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200020
Location15 Hospital DriveYork, ME 03909 · York 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

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

Lincolnhealth

Critical Access Hospitals · Damariscotta, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number201302
Location35 Miles StreetDamariscotta, ME 04543 · Lincoln County
Emergency services

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
$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

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
3%991 patients1/55-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
59%639 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%4,026 patients4/55-star benchmark: 99%
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%213 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.
66%1,673 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…
47%1,654 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
38%1,227 patients2/55-star benchmark: 88%
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…
97%1,673 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…
37%1,673 patients2/55-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.
53%1,673 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 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
6 suppliers44 claims563 services$17.94 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
5 suppliers43 claims1,400 services$2.39 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
4 suppliers33 claims33 services$174.95 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
39 suppliers117 claims503 services$6.26 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
12 suppliers25 claims30 services$1.13 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
2 suppliers38 claims38 services$306.47 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 7

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

Dermatology
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Dermatology
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Nurse Practitioner
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Dermatology
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Nurse Practitioner (Family)
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Nurse Practitioner (Family)
71 US ROUTE 1 STE J
SCARBOROUGH, ME 04074
Physician Assistant
71 US ROUTE 1 STE J
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 Stephan Babirak's NPI number?

The NPI number for Stephan Babirak is 1689619884. It was assigned to this individual provider in the NPPES registry on June 19, 2006.

Where is Stephan Babirak located?

Stephan Babirak practices at 71 Us Route 1 Ste J, Scarborough, ME 04074. The listed phone number is (207) 396-6433.

What is Stephan Babirak's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Stephan Babirak enrolled in Medicare?

Yes. Stephan Babirak 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 Stephan Babirak accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Stephan Babirak 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 Stephan Babirak affiliated with any hospitals?

According to CMS data, Stephan Babirak is affiliated with Maine Medical Center, York Hospital, Mid Coast Hospital, Maine General Medical Center and Lincolnhealth.

When was this NPI record last updated?

The NPPES record for Stephan Babirak was last updated on March 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.