Individual provider Active NPI

Emil Peter Miskovsky, MD

  • Gastroenterology Physician
  • Lewiston, ME
National Provider Identifier
1427043942
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD19652 Issued in ME
Practice address
93 Campus Ave
Lewiston, ME 04240-6030
Phone
(207) 755-3636
Fax
(207) 755-3652
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0420010255 VT
Gastroenterology Physician 207RG0100X MD19652 ME Primary
Gastroenterology Physician 207RG0100X 291445 NY

Addresses

Primary practice location

93 Campus Ave
Lewiston, ME 04240-6030

Mailing address

C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243
Phone (207) 777-8950

Other practice location 1

110 Business Park Drive
Utica, NY 13502
Phone (315) 624-7000

Other practice location 2

360 Broadway Ste 100
Bangor, ME 04401-3985
Phone (207) 907-3550

Other practice location 3

4 Glen Cove Dr
Rockport, ME 04856-4235
Phone (207) 301-5790

Other identifiers 3

IdentifierTypeStateIssuer
1007971MedicaidVT
58290OtherVTBLUE CROSS AND BLUE SHIEL
105305OtherVTMVP

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130801000316 ME Practitioner - Gastroenterology 8123059706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-4420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Upper gastrointestinal (GI) endoscopy for acid reflux27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291445NYMDGastroenterology Physician
0420010255VTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Regional Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Mainehealth CurrentSince Feb 1, 2024 Accepting new patients
St. Joseph Hospital CurrentSince Jan 11, 2021 Accepting new patients
Mainehealth Current Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jul 13, 2020 Accepting new patients
Mainehealth CurrentSince Feb 1, 2024 Accepting new patients
Southwestern Vermont Medical Center Inc. Past Accepting new patients

Locations

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
Ste 100
Bangor, ME 04401
Phone (207) 907-3550

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4420

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

4 Glen Cove Dr
Rockport, ME 04856
Phone (207) 301-5500

Interoperability endpoints

  • Direct secure messaging: emiskovsky1153859@direct.bsmhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1427043942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04243",
            "telephone_number": "207-777-8950",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406030",
            "telephone_number": "207-755-3636",
            "fax_number": "207-755-3652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Business Park Drive",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "13502",
            "country_code": "US",
            "telephone_number": "315-624-7000",
            "fax_number": "315-793-1129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Broadway Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013985",
            "country_code": "US",
            "telephone_number": "207-907-3550",
            "fax_number": "207-907-3562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Glen Cove Dr",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "048564235",
            "country_code": "US",
            "telephone_number": "207-301-5790",
            "fax_number": "207-301-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISKOVSKY",
        "first_name": "EMIL",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VT",
            "license": "0420010255",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD19652",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "291445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007971",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "58290",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "105305",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.