Organization Active NPI

Sebasticook Medical Specialists

  • Surgery Physician
  • Bangor, ME
National Provider Identifier
1295905271
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SEBASTICOOK MEDICAL SPECIALISTS
Practice address
470 State Street
Suite 210
Bangor, ME 04401
Phone
(207) 973-4878
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Emily Edgar
Title
Director of Patient Accounts
Phone
(207) 487-0916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

470 State Street
Suite 210
Bangor, ME 04401

Mailing address

PO Box 810
Westbrook, ME 04098-0810
Phone (207) 854-1544

Other identifiers 1

IdentifierTypeStateIssuer
HX3558OtherMEMEDICARE INDIVIDUAL NUMBE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1295905271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040980810",
            "telephone_number": "207-854-1544",
            "fax_number": "207-854-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 STATE STREET",
            "address_2": "SUITE 210",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-973-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTICOOK MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "207-487-0916"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL NUMBE",
            "identifier": "HX3558",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.