Roger R Gagnon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT740 Issued in ME

Practice address

510 Mainemall Rd.
South Portland, ME 04106

Phone

(207) 775-2030

Fax

(207) 775-0755

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Kaper

  • Optometrist
  • Waterville, ME
  • NPI 1558711531
  Medicare reassignment
• Kirsten Weitzel Turrisi, OD

  • Optometrist
  • South Portland, ME
  • NPI 1770135618
  Medicare reassignment

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1124128913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MAINEMALL ROAD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-775-2030",
            "fax_number": "207-775-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MAINEMALL RD.",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-775-2030",
            "fax_number": "207-775-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "ROGER",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121300099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly B Frost, CNM
• Sarah Fuhrman, FNP
• Full Potential PLLC
• G6 Genomics, LLC
• Kalyn Gagnon, DPT
• Samuel Gagnon, PA-C
• Gaia Enterprises Inc
• Kenneth Galeckas, M.D.
• Erin Sandy Gallagher, FNP
• Kirsten Ueland Gallery, PA

• Optometrist in South Portland, ME
• Providers in South Portland, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.