Individual provider Active NPI

Gregory D'Augustine, M.D.

  • Surgery Physician
  • Lewiston, ME
National Provider Identifier
1093737553
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
010697 Issued in ME
Practice address
10 High St
Suite 202
Lewiston, ME 04240-7640
Phone
(207) 784-2903
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 010697 ME Primary

Addresses

Primary practice location

10 High St
Suite 202
Lewiston, ME 04240-7640

Mailing address

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

Other identifiers 7

IdentifierTypeStateIssuer
3544908OtherMECIGNA
4002657OtherMEAETNA-NON HMO
E001664OtherMECHAMPUS
E34486OtherMEHARVARD
0931737OtherMEAETNA
002313OtherMEANTHEM BCBS
M58331OtherMECIGNA HEALTHSOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060816000429 ME Practitioner - General Surgery 8628071495 Practice locations: Lewiston, ME

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010697MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sirus Hamzavi, MD LLC PA Past Accepting new patients

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093737553",
    "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": "207-777-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HIGH ST",
            "address_2": "SUITE 202",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407640",
            "telephone_number": "207-784-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AUGUSTINE",
        "first_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "010697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3544908",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-NON HMO",
            "identifier": "4002657",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "E001664",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "E34486",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0931737",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "002313",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "M58331",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.