Individual provider Active NPI

Jacob Marceau, DO

  • Emergency Medicine Physician
  • Skowhegan, ME
National Provider Identifier
1609372465
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO3165 Issued in ME
Practice address
46 Fairview Ave
Skowhegan, ME 04976-1481
Phone
(207) 474-5121
Fax
(207) 474-3441
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO3165 ME Primary

Addresses

Primary practice location

46 Fairview Ave
Skowhegan, ME 04976-1481

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-5121

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
I20210830002665 ME Practitioner - Emergency Medicine 2365790466 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

46 Fairview Ave
Skowhegan, ME 04976-1481
Phone (207) 474-5121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO3165MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Aug 1, 2021 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 1, 2021 Accepting new patients
Redington-Fairview General Hospital CurrentSince Nov 1, 2022 Accepting new patients
Redington-Fairview General Hospital CurrentSince Nov 1, 2022 Accepting new patients

Locations

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: jacob.marceau@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1609372465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-474-5121",
            "fax_number": "207-474-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-5121",
            "fax_number": "207-474-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCEAU",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "DO3165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.