Lucille Jean Poulin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

014565 Issued in ME

Practice address

32 Resort Way
Ellsworth Family Practice
Ellsworth, ME 04605

Phone

(207) 664-7770

Fax

(207) 664-7723

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 8, 2024 through Jan 8, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1144269150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 UNION ST",
            "address_2": "ELLSWORTH FAMILY PRACTICE",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051534",
            "telephone_number": "207-664-7770",
            "fax_number": "207-664-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "address_2": "ELLSWORTH FAMILY PRACTICE",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "04605",
            "telephone_number": "207-664-7770",
            "fax_number": "207-664-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIN",
        "first_name": "LUCILLE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "014565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245160099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert L Pinsky, MD
• Joan Piskura, CADC
• Susan Polyot, LADC, CCS
• Debra Lynn Porter, CNM
• Janet Pottle, MHRT-CSP
• Elizabeth Joanne Pouwels, RN
• Primary Health, LLC
• Primary Health, LLC
• Prime Care Medical Supplies, Inc
• Pro-Med, Inc. (Center for Sleep Disorders)

• Family Medicine Physician in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.