Michael R Sivulich, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

11922 Issued in ME

Practice address

93 Campus Ave
Lewiston, ME 04240-6030

Phone

(207) 755-3636

Fax

(207) 755-3652

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: msivulich1155816@direct.bsmhealth.org

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1639155393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8553",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CAMPUS AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406030",
            "telephone_number": "207-755-3636",
            "fax_number": "207-755-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVULICH",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "11922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100005851",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1040131",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309480099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "002390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abhay K Singh, MD
• Ruby Singh, MD
• Katrina Lynn Sink, MD
• Sirus Hamzavi, MD LLC PA
• Peter R Siviski, M.D.
• Collin R Skilling, OTR/L
• Henry C. Skinner, MD
• John W Skinner, M.D.
• Kryse S. Skye, LCSW
• Maura E Slater, OT

• Gastroenterology Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Gastroenterology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.