Leroy Victor Danielson
Individual provider Active NPI Emergency Medicine Physician · Machias, ME
NPI 1285925537 · NPPES record last updated Jul 1, 2019
Key facts
- NPI
- 1285925537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD21872 (ME)
- Practice address
- 11 Hospital Dr
Machias, ME 04654 - Phone
- (207) 255-3356
- NPI assigned
- Apr 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 14
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- York Hospital
Houlton Regional Hospital
Bluewater Emergency Partners of Brunswick, LLC
Practice addresses (Care Compare)
15 Hospital Dr
York, ME 03909-1011
Phone (207) 363-4321
20 Hartford St
Houlton, ME 04730-1891
Phone (207) 532-2900
24 Hospital LN
Calais, ME 04619-1329
Phone (207) 454-7521
Hospital & facility affiliations
- Houlton Regional Hospital
- Central Maine Medical Center
- Rumford Hospital
- York Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ME, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180227001404 | ME | Practitioner - Emergency Medicine | 9537394945 | Reassigns benefits to 5 organizations |
| I20200508002224 | NY | Practitioner - Emergency Medicine | 9537394945 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Down East Community Hospital | Current |
Accepting new patients | |
| Maimonides Medical Center - MMC Emergency Physicians FPP | Emergency Medicine | Current |
Accepting new patients |
| Houlton Regional Hospital | Current |
Accepting new patients | |
| York Hospital | Current |
Accepting new patients | |
| Bluewater Emergency Partners of Brunswick, LLC | Emergency Medicine | Current |
Accepting new patients |
| Houlton Regional Hospital | Current |
Accepting new patients | |
| Seacoast Pathology Inc | Current | Accepting new patients | |
| Down East Community Hospital | Current |
Accepting new patients | |
| Houlton Regional Hospital | Past | Accepting new patients | |
| Bluewater Emergency Partners of Calais, LLC Dba: Bluewater Urgent Care | Emergency Medicine | Past | Accepting new patients |
Locations
123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800
24 Hospital Ln
Calais, ME 04619
Phone (207) 454-9213
20 Hartford St
Houlton, ME 04730
Phone (207) 532-2900
11 Hospital Dr
Machias, ME 04654
Phone (207) 255-0434
15 Hospital Dr
York, ME 03909
Phone (207) 351-2478
243 Elm St
Claremont, NH 03743
Phone (603) 542-7771
4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6b68bc92-a317-4686-a79a-fbb1b58a509e/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD2014-0219 | NM | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | MD21872 | ME | Yes |
Addresses
Primary practice location
11 Hospital Dr
Machias, ME 04654
Mailing address
14 Maine St # 44
Brunswick, ME 04011-2049
Phone (207) 725-9065
Other practice location 1
14 Maine St # 44
Brunswick, ME 04011-2049
Phone (207) 725-9065
Other practice location 2
Unm Department Of Emergency Medicine
MSC11 6025 1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-5062
Other practice location 3
14 Maine St # 44
Brunswick, ME 04011-2049
Phone (207) 725-9065
Other providers in Machias, ME
- Nicholas Joachim Coetzee
- Melissa Courtemanche
- Erin Leigh Crowley
- Melessa Cunningham
- Crystal J. Cushing
- David C. Rioux, D.O.
- Davis Long Term Care Group Inc
- Davis Long Term Care Group Inc
- Deborah Day
- Michelle Del Tufo
All providers in Machias, ME · Emergency Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.