Individual provider Active NPI

Sarah Jayne Gladstone, O.D.

  • Optometrist
  • Bangor, ME
National Provider Identifier
1285829333
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT897 Issued in ME
Practice address
824 Stillwater Ave
Bangor, ME 04401-3614
Phone
(207) 947-7554
Fax
(207) 945-0085
NPI assigned
Sep 12, 2007
Last updated
Sep 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT897 ME Primary

Addresses

Primary practice location

824 Stillwater Ave
Bangor, ME 04401-3614

Mailing address

824 Stillwater Ave
Bangor, ME 04401-3614
Phone (207) 947-7554

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071110000049 ME Practitioner - Optometry 2668560590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smart Vision LLCGroup PAC ID 8022393230, 8 clinicians

Practice addresses (Care Compare)

824 Stillwater Ave
Bangor, ME 04401-3614
Phone (207) 947-7554

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT897MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Vision, LLC Optometrist CurrentSince Mar 10, 2017 Accepting new patients
Smart Vision, LLC Optometrist CurrentSince Mar 9, 2017 Accepting new patients

Locations

255 Western Ave
Augusta, ME 04330
Phone (207) 622-5800

824 Stillwater Ave
Bangor, ME 04401
Phone (207) 947-7554

210 Maine Ave
Farmingdale, ME 04344
Phone (207) 582-5800

484 Maine Ave
Farmingdale, ME 04344
Phone (207) 582-5800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1285829333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013614",
            "telephone_number": "207-947-7554",
            "fax_number": "207-945-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013614",
            "telephone_number": "207-947-7554",
            "fax_number": "207-945-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "SARAH",
        "middle_name": "JAYNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.