Individual provider Active NPI

Anthony Lee Sintetos, M.D., PH.D.

  • Cardiovascular Disease Physician
  • Waterville, ME
National Provider Identifier
1336147222
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
018031 Issued in ME
Practice address
244 Kennedy Memorial Dr
First Floor
Waterville, ME 04901-4538
Phone
(207) 861-8030
Fax
(207) 861-8317
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X G56989 CA
Cardiovascular Disease Physician 207RC0000X 018031 ME Primary

Addresses

Primary practice location

244 Kennedy Memorial Dr
First Floor
Waterville, ME 04901-4538

Mailing address

174 Kennedy Memorial Dr
Waterville, ME 04901-5134
Phone (800) 395-0232

Other identifiers 1

IdentifierTypeStateIssuer
434197399MedicaidME

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1336147222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015134",
            "telephone_number": "800-395-0232",
            "fax_number": "207-861-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 KENNEDY MEMORIAL DR",
            "address_2": "FIRST FLOOR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014538",
            "telephone_number": "207-861-8030",
            "fax_number": "207-861-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINTETOS",
        "first_name": "ANTHONY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G56989",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "018031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434197399",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.