Individual provider Active NPI

Robert D Livingston Jr., MD

  • Orthopaedic Surgery Physician
  • Brunswick, ME
National Provider Identifier
1649251273
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
012764 Issued in ME
Practice address
430 Bath Road
Suite 102
Brunswick, ME 04011
Phone
(207) 442-0350
Fax
(207) 442-0355
NPI assigned
Nov 10, 2005
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 88329 FL
Orthopaedic Surgery Physician 207X00000X 012764 ME Primary

Addresses

Primary practice location

430 Bath Road
Suite 102
Brunswick, ME 04011

Mailing address

430 Bath Rd
Suite 102
Brunswick, ME 04011-2637
Phone (207) 442-0350

Other identifiers 2

IdentifierTypeStateIssuer
23094099MedicaidME
230940099MedicaidME

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
88329FLMDOrthopaedic Surgery Physician
012764MEMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine,P.a. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1649251273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BATH RD",
            "address_2": "SUITE 102",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112637",
            "telephone_number": "207-442-0350",
            "fax_number": "207-442-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BATH ROAD",
            "address_2": "SUITE 102",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-442-0350",
            "fax_number": "207-442-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "88329",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "012764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23094099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230940099",
            "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 Jan 21, 2015; 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.