Individual provider Active NPI

Peter F Morse, O.D.

  • Optometrist
  • South Portland, ME
National Provider Identifier
1407807126
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT628 Issued in ME
Practice address
213 Maine Mall Rd
South Portland, ME 04106-2312
Phone
(207) 774-8008
Fax
(207) 774-0990
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT628 ME Primary

Addresses

Primary practice location

213 Maine Mall Rd
South Portland, ME 04106-2312

Mailing address

213 Maine Mall Rd
South Portland, ME 04106-2312
Phone (207) 774-8008

Other identifiers 2

IdentifierTypeStateIssuer
200460099MedicaidME
038256OtherMEANTHEM

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

State licenses

LicenseStateTypeSpecialty
OPT628MEMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1407807126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MAINE MALL RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062312",
            "telephone_number": "207-774-8008",
            "fax_number": "207-774-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 MAINE MALL RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062312",
            "telephone_number": "207-774-8008",
            "fax_number": "207-774-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSE",
        "first_name": "PETER",
        "middle_name": "F",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200460099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "038256",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.