Paul Terence Dube, M.D.
Individual provider Active NPI Pediatrics Physician · Belfast, ME
NPI 1699738310 · NPPES record last updated Dec 21, 2022
Key facts
- NPI
- 1699738310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD26350 (ME)
- Practice address
- 53 Schoodic Dr
Belfast, ME 04915-7246 - Phone
- (207) 338-6900
- Fax
- (207) 338-4974
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221201001074 | ME | Practitioner - Pediatric Medicine | 8729012208 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37248 | CO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Community Health Center | Current |
Accepting new patients | |
| Penobscot Community Health Center | Current |
Accepting new patients | |
| River Valley Pediatrics, PC | Pediatrics | Past |
Accepting new patients |
Locations
1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407
29 Schoodic Dr
Belfast, ME 04915
Phone (207) 218-6001
53 Schoodic Dr
Belfast, ME 04915
Phone (207) 338-6900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 37248 | CO | |
| Pediatrics Physician | 208000000X | MD26350 | ME | Yes |
Addresses
Primary practice location
53 Schoodic Dr
Belfast, ME 04915-7246
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Other practice location 1
2828 International Cir
Ste 140
Colorado Springs, CO 80910-3127
Phone (719) 632-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17876052 | Medicaid | CO |
Other providers in Belfast, ME
- Dirigo Consulting
- Dr Kerri Vacher LLC
- Dr. Michael Wright, LCSW
- DRS. Dutch & Marnecheck,LLC
- Morgan Amber Dube
- Jessie Martel Dunson Todd
- Elizabeth V Durham
- Jeffery J Dutch
- Jennifer C Eaton
- Matthew Thomas Economy
All providers in Belfast, ME · Pediatrics Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.