Individual provider Active NPI

Sydney R Sewall, MD

  • Pediatrics Physician
  • Augusta, ME
National Provider Identifier
1073589594
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
011090 Issued in ME
Practice address
15 E Chestnut St
Augusta, ME 04330-5736
Phone
(207) 626-1561
Fax
(207) 626-1849
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 011090 ME Primary

Addresses

Primary practice location

15 E Chestnut St
Augusta, ME 04330-5736

Mailing address

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525001108 ME Practitioner - Pediatric Medicine 5395787790 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011090MEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Nov 1, 2013 Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

442 Civic Center Dr
Augusta, ME 04330
Phone (207) 622-6319

6 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1236

150 Dresden Ave
Gardiner, ME 04345
Phone (207) 621-9337

152 Dresden Ave
Gardiner, ME 04345
Phone (207) 582-6608

149 North St
Waterville, ME 04901
Phone (207) 622-1959

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1073589594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305736",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEWALL",
        "first_name": "SYDNEY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "011090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.