Active NPI
Peter J Jederlinic, M.D.
- Pulmonary Disease Physician
- Lewiston, ME
National Provider Identifier
1710943378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 018700
- Practice address
- 76 High St
Ste 300
Lewiston, ME 04240-7649 - Phone
- (207) 795-5544
- Fax
- (207) 795-5645
- NPI assigned
- Apr 24, 2006
- Last updated
- Sep 30, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 018700 | ME | |
| Pulmonary Disease Physician | 207RP1001X | 018700 | ME | Primary |
Addresses
Primary practice location
76 High St
Ste 300
Lewiston, ME 04240-7649
Mailing address
76 High St
Ste 300
Lewiston, ME 04240-7649
Phone (207) 795-5544
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
| License | State | Type | Specialty |
|---|---|---|---|
| 018700 | ME | MD | Critical Care Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1710943378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 HIGH ST",
"address_2": "STE 300",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407649",
"telephone_number": "207-795-5544",
"fax_number": "207-795-5645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 HIGH ST",
"address_2": "STE 300",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407649",
"telephone_number": "207-795-5544",
"fax_number": "207-795-5645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDERLINIC",
"first_name": "PETER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-24",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "ME",
"license": "018700",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "ME",
"license": "018700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.