Eastern Maine Eye Associates PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EASTERN MAINE EYE ASSOCIATES PA

Practice address

900 Hammond St # a
Bangor, ME 04401-4378

Phone

(207) 947-6743

Fax

(207) 945-4397

NPI assigned

Oct 26, 2005

Last updated

Jun 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Garth Allen Wilbanks, MDNPI 1265420640

Title

President

Phone

(207) 947-6743

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Tax ID family

Eastern Maine Eye Associa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eastern Maine Eye Associates, PA

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1013314483
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Garth Allen Wilbanks, MD

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1265420640
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Jay Jordan, MD

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1861480246
  Medicare reassignment Care Compare group NPD
• Marina Peskina, MD

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1487113486
  Medicare reassignment Care Compare group NPD
• Cynthia Amanda Self, MD

  • Ophthalmology Physician
  • Bangor, ME
  • NPI 1275521650
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1679563076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HAMMOND ST # A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014378",
            "telephone_number": "207-947-6743",
            "fax_number": "207-945-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HAMMOND ST # A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014378",
            "telephone_number": "207-947-6743",
            "fax_number": "207-945-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MAINE EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "WILBANKS",
        "authorized_official_first_name": "GARTH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-947-6743",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127470000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Hwnry Dwelley, O. D.
• Shelly Marie Dyer, LCPC
• Thomas Earl, MD
• Eastern Area Agency on Aging
• Eastern Maine Counseling and Testing Services, Inc.
• Eastern Maine Eye Associates, PA
• Eastern Maine Homecare (Bangor Area Visiting Nurses)
• Eastern Maine Homecare (Hospice of Eastern Maine)
• Eastern Maine Medical Center
• Eastern Maine Medical Center

• Ophthalmology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Ophthalmology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.