NPIMap

Individual provider Active NPI

Edward J Dunstan, DO

  • Family Medicine Physician
  • Millinocket, ME
National Provider Identifier
1043288525
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1716 Issued in ME
Practice address
200 Somerset St
Suite 3
Millinocket, ME 04462-1258
Phone
(207) 723-5173
Fax
(207) 723-3040
NPI assigned
Mar 9, 2006
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO1716 ME Primary

Addresses

Primary practice location

200 Somerset St
Suite 3
Millinocket, ME 04462-1258

Mailing address

200 Somerset St
Suite 3
Millinocket, ME 04462-1258
Phone (207) 723-5173

Other identifiers 2

IdentifierTypeStateIssuer
2182097OtherFIRST HEALTH
7411174OtherAETNA US HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050131000232 ME Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1254381908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Rowan University School of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millinocket Regional HospitalGroup PAC ID 3779491212, 17 clinicians

Practice addresses (Care Compare)

200 Somerset St
Millinocket, ME 04462-1258
Phone (207) 723-5173

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1716MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millinocket Regional Hospital CurrentSince Feb 1, 2004 Accepting new patients
Millinocket Regional Hospital CurrentSince Feb 1, 2004 Accepting new patients
Katahdin Health Care LLC Past Accepting new patients
Millinocket Regional Hospital Past Accepting new patients
Millinocket Regional Hospital Past Accepting new patients

Locations

200 Somerset St
Millinocket, ME 04462
Phone (207) 723-3003

200 Somerset St
Ste 3
Millinocket, ME 04462
Phone (207) 723-3329

899 Central St
Millinocket, ME 04462
Phone (207) 723-5173

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/millin-5897075c

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Millinocket Regional HospitalMillinocket, ME, CCN 201307 Hospital Corporate Director Jul 1, 2023
Millinocket Regional HospitalMillinocket, ME, CCN 20Z307 Hospital Corporate Director Jul 1, 2023
Millinocket Regional HospitalMillinocket, ME, CCN 208520 Rural health clinic Corporate Director Mar 25, 2013
Millinocket Regional HospitalMillinocket, ME, CCN 208521 Rural health clinic Corporate Director Jul 1, 2012

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 5

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1043288525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOMERSET ST",
            "address_2": "SUITE 3",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044621258",
            "telephone_number": "207-723-5173",
            "fax_number": "207-723-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOMERSET ST",
            "address_2": "SUITE 3",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044621258",
            "telephone_number": "207-723-5173",
            "fax_number": "207-723-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNSTAN",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO1716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2182097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7411174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millinocket, ME

Sources for this page

Verify at the official NPI Registry.