NPIMap

Organization Active NPI

Maine Eye Center, PA

  • Ophthalmology Physician
  • Portland, ME
National Provider Identifier
1720044878
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MAINE EYE CENTER, PA
Practice address
15 Lowell St
Portland, ME 04102-2776
Phone
(207) 774-8277
Fax
(207) 523-5310
NPI assigned
Apr 25, 2006
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Judith McCann
Title
Director of Revenue Cycle
Phone
(848) 219-2109

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Corneal and Contact Management Optometrist 152WC0802X NU
Contact Lens Technician/Technologist 156FC0800X NU
Ophthalmic Assistant 156FX1101X NU
Optometric Technician 156FX1202X NU
Optician 156FX1800X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

15 Lowell St
Portland, ME 04102-2776

Mailing address

15 Lowell St
Portland, ME 04102-2776
Phone (207) 774-8277

Other identifiers 12

IdentifierTypeStateIssuer
106700200MedicaidME
9720OtherNHNH CIGNA HEALTHSOURCE GRO
000335OtherMEANTHEM FACILITY GROUP #
106700300MedicaidME
M187212OtherMECIGNA HS FACILITY GROUP
2359120OtherMEAETNA FACILITY GROUP #
490000770OtherMERAILROAD FACILITY GROUP #
E00118OtherMECHAMPUS GROUP #
99904863MedicaidNH
106700000MedicaidME
106700100MedicaidME
M304OtherMECIGNA HEALTHSOURCE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518000880 ME Part B Supplier - Clinic/Group Practice 0446240634 Receives reassigned benefits from 20 practitioners
Practice locations: Portland, ME; Westbrook, ME

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: bfowler@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: bmiller@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: clibby@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: hmccarthy@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: jberman@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: jmoore@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: jwalters@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: mthees@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: nacord@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: rbazarian@maineeyecenter.intellechartdirect.net
  • Direct secure messaging: srose@maineeyecenter.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1720044878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022776",
            "telephone_number": "207-774-8277",
            "fax_number": "207-523-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LOWELL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022776",
            "telephone_number": "207-774-8277",
            "fax_number": "207-523-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE EYE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "848-219-2109"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1101X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1202X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106700200",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH CIGNA HEALTHSOURCE GRO",
            "identifier": "9720",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FACILITY GROUP #",
            "identifier": "000335",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106700300",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HS FACILITY GROUP",
            "identifier": "M187212",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FACILITY GROUP #",
            "identifier": "2359120",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD FACILITY GROUP #",
            "identifier": "490000770",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS GROUP #",
            "identifier": "E00118",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99904863",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106700000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106700100",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE GROUP",
            "identifier": "M304",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.