Individual provider Active NPI

Peter E Giustra, M.D.

  • Diagnostic Radiology Physician
  • Rockport, ME
National Provider Identifier
1033113527
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
006374 Issued in ME
Practice address
6 Glen Cove Dr
Rockport, ME 04856-4240
Phone
(207) 596-8000
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 006374 ME
Diagnostic Radiology Physician 2085R0202X 006374 ME Primary

Addresses

Primary practice location

6 Glen Cove Dr
Rockport, ME 04856-4240

Mailing address

PO Box 1849
Lewiston, ME 04241-1849
Phone (207) 784-2554

Other identifiers 1

IdentifierTypeStateIssuer
303680099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006374MEMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Mobile MRI Assoc Diagnostic Radiology PastSince Nov 1, 1989 Accepting new patients
Pen Bay Womens Imaging Specialists Diagnostic Radiology PastSince Jul 1, 1970 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1033113527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411849",
            "telephone_number": "207-784-2554",
            "fax_number": "207-783-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GLEN COVE DR",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048564240",
            "telephone_number": "207-596-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIUSTRA",
        "first_name": "PETER",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "ME",
            "license": "006374",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "006374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303680099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.