Active NPI
Owen B Pickus, D.O.
- Hematology & Oncology Physician
- Westbrook, ME
National Provider Identifier
1174565667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 977
- Practice address
- 2 Chabot St
Westbrook, ME 04092-4817 - Phone
- (207) 857-9311
- Fax
- (207) 857-9324
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 977 | ME | Primary |
Addresses
Primary practice location
2 Chabot St
Westbrook, ME 04092-4817
Mailing address
2 Chabot St
Westbrook, ME 04092-4817
Phone (207) 857-9311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110890199 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 977 | ME | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262044800000",
"number": "1174565667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 CHABOT ST",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040924817",
"telephone_number": "207-857-9311",
"fax_number": "207-857-9324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CHABOT ST",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040924817",
"telephone_number": "207-857-9311",
"fax_number": "207-857-9324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKUS",
"first_name": "OWEN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-11",
"last_updated": "2009-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "ME",
"license": "977",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110890199",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.