Douglas M Morong, PA-C – Physician Assistant

Key facts

NPI: 1295787448
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: PA-503 (ME)
Practice address: 376 Main St
Jackman, ME 04945-5214
Phone: (207) 668-2691
Fax: (207) 668-7605
NPI assigned: May 16, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Orono Medical Center Health Maintenance Organization · Orono, ME · NPI 1295784486

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
PA-503	ME	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Orono Medical Center		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	PA-503	ME	Yes

Addresses

Primary practice location

376 Main St
Jackman, ME 04945-5214

Mailing address

376 Main St
Jackman, ME 04945-5214
Phone (207) 668-2691

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 3, 2008.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1295787448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 MAIN ST",
            "city": "JACKMAN",
            "state": "ME",
            "postal_code": "049455214",
            "telephone_number": "207-668-2691",
            "fax_number": "207-668-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 MAIN ST",
            "city": "JACKMAN",
            "state": "ME",
            "postal_code": "049455214",
            "telephone_number": "207-668-2691",
            "fax_number": "207-668-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONG",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA-503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackman, ME

All providers in Jackman, ME · Physician Assistant 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 3, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.