Active NPI
Gilbert M Wilcox, MD
- Specialist
- Portland, ME
National Provider Identifier
1750446936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0102139
- Practice address
- 161 Marginal Way
Portland, ME 04101-2438 - Phone
- (207) 773-7964
- Fax
- (207) 773-9073
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0102139 | ME | Primary |
Addresses
Primary practice location
161 Marginal Way
Portland, ME 04101-2438
Mailing address
161 Marginal Way
Portland, ME 04101-2438
Phone (207) 774-3461
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100003458 | Other | ME | RAILROAD MEDICARE |
| 01-0418797 | Other | ME | FEDERAL TAX ID |
| 117070000 | Medicaid | ME | |
| E001889 | Other | ME | TRICARE |
| 037916 | Other | ME | ANTHEM STAR NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102139 | ME | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1750446936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 MARGINAL WAY",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041012438",
"telephone_number": "207-774-3461",
"fax_number": "207-774-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 MARGINAL WAY",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041012438",
"telephone_number": "207-773-7964",
"fax_number": "207-773-9073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "GILBERT",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ME",
"license": "0102139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "100003458",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "01-0418797",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117070000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "E001889",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM STAR NUMBER",
"identifier": "037916",
"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 Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.