Todd D O'Brien, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Old Town, ME
NPI 1366401291 · NPPES record last updated May 5, 2021
Key facts
- NPI
- 1366401291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- POD1016 (ME)
- Practice address
- 242 Brunswick St
Old Town, ME 04468-1613 - Phone
- (207) 827-6128
- Fax
- (207) 827-6605
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050614001018 | ME | Practitioner - Podiatry | 6800830555 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD1016 | ME | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Valley Hospital | Current |
Accepting new patients | |
| Penobscot Valley Hospital | Current |
Accepting new patients |
Locations
7 Transalpine Rd
Lincoln Ctr, ME 04457
Phone (207) 794-3321
Interoperability endpoints
- todd.o.brien.1@5664.direct.athenahealth.com
- https://api.platform.athenahealth.com/5664/brand/1/csg/1/fhir/r4
- https://fhir-usa.unify.chbase.com/org/penob-eadbba22
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | POD1016 | ME | Yes |
Addresses
Primary practice location
242 Brunswick St
Old Town, ME 04468-1613
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030284 | Other | ME | ANTHEM |
| 480034965 | Other | ME | MEDICARE PTAN |
| 154750099 | Medicaid | ME | |
| 201839 | Other | ME | NGS |
Other providers in Old Town, ME
- Gabrielle N Neill
- Regan Lauren Nelson
- Tessa T Nguyen
- Evelyn Dorothy Niles
- Noonan Chiropractic
- Byron Judson Oakes
- Emily Odermann
- Heather D Okeefe
- Old Town Residential Services Corp.
- Old Town School Dept.
All providers in Old Town, ME · Foot & Ankle Surgery Podiatrist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.