Individual provider Active NPI

Garth Allen Wilbanks, MD

  • Ophthalmology Physician
  • Bangor, ME
National Provider Identifier
1265420640
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
014063 Issued in ME
Practice address
900 Hammond St # a
Bangor, ME 04401-4378
Phone
(207) 947-6743
Fax
(207) 945-4397
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 014063 ME Primary

Addresses

Primary practice location

900 Hammond St # a
Bangor, ME 04401-4378

Mailing address

900 Hammond St # a
Bangor, ME 04401-4378
Phone (207) 947-6743

Other identifiers 1

IdentifierTypeStateIssuer
339050099MedicaidME

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000772 ME Practitioner - Ophthalmology 7911940713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Eye Associates PAGroup PAC ID 8820031610, 4 clinicians

Practice addresses (Care Compare)

900 Hammond St
A
Bangor, ME 04401-4378
Phone (207) 947-6743

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014063MEMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Eye Associates PA Ophthalmology CurrentSince Aug 18, 1995 Accepting new patients
Eastern Maine Eye Associates, PA Ophthalmology Current Accepting new patients
Bangor Eye Surgery, PA CurrentSince Oct 4, 2016 Accepting new patients

Locations

900 Hammond St
Ste A
Bangor, ME 04401

885 Union St
Ste 120
Bangor, ME 04401
Phone (207) 947-6743

900 Hammond St
#A
Bangor, ME 04401
Phone (207) 947-6743

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1265420640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HAMMOND ST # A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014378",
            "telephone_number": "207-947-6743",
            "fax_number": "207-945-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HAMMOND ST # A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014378",
            "telephone_number": "207-947-6743",
            "fax_number": "207-945-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "GARTH",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "014063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339050099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.