Active NPI
Robert Clark Vilas, PH.D.
- Psychologist
- Brunswick, ME
National Provider Identifier
1629198668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 874
- Practice address
- 240 Maine St
Brunswick, ME 04011-3365 - Phone
- (207) 725-4700
- Fax
- (207) 725-4765
- NPI assigned
- Mar 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 874 | ME | Primary |
Addresses
Primary practice location
240 Maine St
Brunswick, ME 04011-3365
Mailing address
240 Maine St
Brunswick, ME 04011-3365
Phone (207) 725-4700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 026544 | Other | ME | ANTHEM BCBS PIN |
| 2211595 | Other | ME | CIGNA PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2014 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 874 | ME | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgetree Counseling & Consultation, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Brunswick, ME
- NPI 1225583255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629198668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 MAINE ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040113365",
"telephone_number": "207-725-4700",
"fax_number": "207-725-4765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 MAINE ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040113365",
"telephone_number": "207-725-4700",
"fax_number": "207-725-4765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILAS",
"first_name": "ROBERT",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS PIN",
"identifier": "026544",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN",
"identifier": "2211595",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.