Individual provider Active NPI

Carl D Robinson, MD

  • Neurology Physician
  • Lewiston, ME
National Provider Identifier
1639103997
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD15578 Issued in ME
Practice address
99 Campus Ave Ste 402
Lewiston, ME 04240-6045
Phone
(207) 777-4455
Fax
(207) 777-4458
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD15578 ME Primary

Addresses

Primary practice location

99 Campus Ave Ste 402
Lewiston, ME 04240-6045

Mailing address

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

Other practice location 1

117 Auburn St
Portland, ME 04103-6003
Phone (207) 797-4791

Other practice location 2

900 Broadway
Bangor, ME 04401-1900
Phone (207) 907-3300

Other identifiers 2

IdentifierTypeStateIssuer
330250099MedicaidME
CA0089OtherMEMEDICARE PTAN

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
I20040809000259 ME Practitioner - Neurology 8123090453 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15578MEMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Regional Medical Center CurrentSince Jan 1, 2004 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Jan 1, 2004 Accepting new patients

Locations

900 Broadway
Bangor, ME 04401
Phone (207) 907-3300

99 Campus Ave
Fl 4
Lewiston, ME 04240
Phone (207) 777-4420

99 Campus Ave
Ste 402
Lewiston, ME 04240
Phone (207) 777-4455

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

100 Campus Ave
Ste 205
Lewiston, ME 04240
Phone (207) 777-8974

99 Campus Ave
Lewiston, ME 04240
Phone (207) 777-4455

117 Auburn St
Portland, ME 04103
Phone (207) 797-4445

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1639103997",
    "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": "042437291",
            "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": "99 CAMPUS AVE STE 402",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406045",
            "telephone_number": "207-777-4455",
            "fax_number": "207-777-4458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Auburn St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041036003",
            "country_code": "US",
            "telephone_number": "207-797-4791",
            "fax_number": "207-317-5390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Broadway",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044011900",
            "country_code": "US",
            "telephone_number": "207-907-3300",
            "fax_number": "207-907-1923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "CARL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ME",
            "license": "MD15578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330250099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA0089",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.