Individual provider Active NPI

Mummtaz Noori, MD

  • Family Medicine Physician
  • Lewiston, ME
National Provider Identifier
1124753314
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
EC221076 Issued in ME
Practice address
76 High St
Lewiston, ME 04240-7649
Phone
(207) 795-2800
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 EC221076 ME Primary

Addresses

Primary practice location

76 High St
Lewiston, ME 04240-7649

Mailing address

76 High St
Lewiston, ME 04240-7649
Phone (207) 795-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EC221076MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center PastSince Jul 24, 2022 Accepting new patients
Central Maine Medical Center PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124753314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407649",
            "telephone_number": "207-795-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407649",
            "telephone_number": "207-795-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORI",
        "first_name": "MUMMTAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "EC221076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.