NPIMap

Individual provider Active NPI

Jerrold T. Gale, M.D.

  • Diagnostic Radiology Physician
  • Lewiston, ME
National Provider Identifier
1003860719
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
017280 Issued in ME
Practice address
300 Main St
Lewiston, ME 04240-7027
Phone
(207) 795-2400
Fax
(207) 795-5539
NPI assigned
May 19, 2006
Last updated
Aug 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 24823 KY
Diagnostic Radiology Physician 2085R0202X 017280 ME Primary

Addresses

Primary practice location

300 Main St
Lewiston, ME 04240-7027

Mailing address

30 Blueberry CV
Yarmouth, ME 04096-6526
Phone (207) 847-3574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070606000365 ME Practitioner - Diagnostic Radiology 0446253330 Reassigns benefits to 2 organizations
I20201224000672 CT Practitioner - Diagnostic Radiology 0446253330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Chicago, Pritzker School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Healthcare Partners PAGroup PAC ID 7618871245, 305 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

46 Titus Coan Rd
Killingworth, CT 06419-1447
Phone (844) 947-4259

489 State St
Bangor, ME 04401-6616
Phone (207) 973-8305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017280MEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Mar 21, 2016 Accepting new patients
Spectrum Healthcare Partners, PA Diagnostic Radiology CurrentSince Feb 1, 2021 Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Feb 1, 2021 Accepting new patients
Central Maine Medical Center CurrentSince Mar 21, 2016 Accepting new patients
Guilford Radiology LLC Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients
Ara Health Specialists PA Diagnostic Radiology Past Accepting new patients
Hendersonville Radiological Consultants, P.a. Past Accepting new patients

Locations

1591 Boston Post Rd
Ste 106
Guilford, CT 06437

489 State St
Bangor, ME 04401
Phone (207) 973-8837

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

200 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 861-3000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1003860719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BLUEBERRY CV",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966526",
            "telephone_number": "207-847-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-2400",
            "fax_number": "207-795-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALE",
        "first_name": "JERROLD",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "24823",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "017280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.