Individual provider Active NPI

Louis Jordan Irwin, M.D.

  • Anesthesiology Physician
  • Bangor, ME
National Provider Identifier
1346327749
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0420008251 Issued in VT
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-7000
Fax
(207) 973-5042
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0420008251 VT Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006
Phone (207) 973-5035

Other identifiers 4

IdentifierTypeStateIssuer
00029589OtherVTBLUE SHIELD
833580OtherVTMVP
0VN2424MedicaidVT
8001321OtherVTLADIES FIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20231113002040 MA Practitioner - Family Practice 9032133186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 368-0704

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420008251VTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Sep 30, 2023 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Sep 30, 2023 Accepting new patients
Williamson Hma Physician Management LLC Anesthesiology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1346327749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7000",
            "fax_number": "207-973-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "LOUIS",
        "middle_name": "JORDAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "0420008251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00029589",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "833580",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2424",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADIES FIRST",
            "identifier": "8001321",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.