Individual provider Active NPI

Marybeth Dunston Ford, MD

  • Ophthalmology Physician
  • Brunswick, ME
National Provider Identifier
1083744429
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
012563 Issued in ME
Practice address
8 Mason St
Brunswick, ME 04011-1514
Phone
(207) 729-7971
Fax
(207) 725-7910
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 012563 ME Primary

Addresses

Primary practice location

8 Mason St
Brunswick, ME 04011-1514

Mailing address

8 Mason St
Brunswick, ME 04011-1514
Phone (207) 729-7971

Other identifiers 1

IdentifierTypeStateIssuer
294970099MedicaidME

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
I20050525000680 ME Practitioner - Ophthalmology 9032151584

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012563MEMDOphthalmology Physician

Interoperability endpoints

  • Direct secure messaging: mford364063@direct.mmc.mainehealth.org

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1083744429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MASON ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040111514",
            "telephone_number": "207-729-7971",
            "fax_number": "207-725-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MASON ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040111514",
            "telephone_number": "207-729-7971",
            "fax_number": "207-725-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "MARYBETH",
        "middle_name": "DUNSTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "012563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294970099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.