Organization Active NPI

Seacoast Medical Care, P.a.

  • Internal Medicine Physician
  • Biddeford, ME
National Provider Identifier
1467527705
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SEACOAST MEDICAL CARE, P.A.
Practice address
57 Barra Rd
Suite #1
Biddeford, ME 04005-9448
Phone
(207) 286-3504
Fax
(207) 286-3767
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Dr. Woodrow Davis Lee, D.O.NPI 1902908411
Title
President
Phone
(207) 286-3504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

57 Barra Rd
Suite #1
Biddeford, ME 04005-9448

Mailing address

57 Barra Rd
Suite #1
Biddeford, ME 04005-9448
Phone (207) 286-3504

Other identifiers 3

IdentifierTypeStateIssuer
2732880OtherMEAETNA
M214470OtherMECIGNA
174560000MedicaidME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080922000153 ME Part B Supplier - Clinic/Group Practice 6901973742 Receives reassigned benefits from 2 practitioners
Practice locations: Biddeford, ME

National Provider Directory

National Provider Directory
Tax ID family
Seacoast Medical Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

57 Barra Rd
Ste 1
Biddeford, ME 04005
Phone (207) 286-3504

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1467527705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BARRA RD",
            "address_2": "SUITE #1",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059448",
            "telephone_number": "207-286-3504",
            "fax_number": "207-286-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BARRA RD",
            "address_2": "SUITE #1",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059448",
            "telephone_number": "207-286-3504",
            "fax_number": "207-286-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST MEDICAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WOODROW",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-286-3504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2732880",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M214470",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174560000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.