Individual provider Active NPI

Jorge Pineiro-Vergne, MD

  • Pediatrics Physician
  • Presque Isle, ME
National Provider Identifier
1629091335
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD14897 Issued in ME
Practice address
11 North St
Presque Isle, ME 04769-2296
Phone
(207) 707-3001
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X MD14897 ME
Pediatrics Physician 208000000X MD14897 ME Primary

Addresses

Primary practice location

11 North St
Presque Isle, ME 04769-2296

Mailing address

140 Academy St
Presque Isle, ME 04769-3102
Phone (207) 764-5437

Other identifiers 1

IdentifierTypeStateIssuer
1624091335MedicaidME

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14897MEMDAddiction Medicine (Psychiatry & Neurology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1629091335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693102",
            "telephone_number": "207-764-5437",
            "fax_number": "207-764-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NORTH ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692296",
            "telephone_number": "207-707-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEIRO-VERGNE",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "ME",
            "license": "MD14897",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD14897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624091335",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.