Clinton Lee Delashaw, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

016405 Issued in ME

Practice address

35 Medical Center Pkwy
Augusta, ME 04330-8160

Phone

(207) 621-4116

Fax

(207) 622-4085

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Augusta Surgical Associates

  • Surgery Physician
  • Augusta, ME
  • NPI 1811174188

  Surgery

  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1336216571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PARKWAY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "04330",
            "telephone_number": "207-621-4116",
            "fax_number": "207-622-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-621-4116",
            "fax_number": "207-622-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELASHAW",
        "first_name": "CLINTON",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "016405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402660000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "022763",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Cottle Deblois, RN-CDE
• Decent Health Care LLC
• James P Decourcey, D.O.
• Elita M. Defeo, D.O.
• Barbara Colleen Degen, RN
• Kenneth Delker
• Mark Delmar, CPO
• Samantha Deming-Berr, DO, MPH
• Michael W Deming, LMFT
• Jeffrey W. Dempski, D.O.

• All providers in Augusta, ME
• Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.