Maine Vitreoretinal Consultants, LLC PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

013480 Issued in ME

Legal business name

MAINE VITREORETINAL CONSULTANTS, LLC PA

Practice address

700 Mount Hope Ave
Suite 470
Bangor, ME 04401-5691

Phone

(207) 945-4474

Fax

(207) 941-5913

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Deborah S Hoffert, M.D.

Title

Owner

Phone

(207) 945-4474

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert J Takach, M.D.

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1134294309

  Single Specialty

  NPD (past)
• Thomas E Flynn, M.D.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1316961048
  NPD (past)
• Yu Tang James Su, MD

  • Ophthalmology Physician
  • Mission, TX
  • NPI 1932135043

  Specialist

  NPD (past)

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1295910479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 470",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015691",
            "telephone_number": "207-945-4474",
            "fax_number": "207-941-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 470",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015691",
            "telephone_number": "207-945-4474",
            "fax_number": "207-941-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE VITREORETINAL CONSULTANTS, LLC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "HOFFERT",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-945-4474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ME",
            "license": "013480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127740000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael William Mainen, M.D.
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• Making the Impossible Possible Case Management
• Devon Courtney Malay, APRN

• Specialist in Bangor, ME
• Providers in Bangor, ME by specialty
• Specialist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.