Active NPI
Riverside Eye Center PA
- Ophthalmology Physician
- Lewiston, ME
National Provider Identifier
1780879510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 015596
- Legal business name
- RIVERSIDE EYE CENTER PA
- Practice address
- 475 Lisbon St
Lewiston, ME 04240-7418 - Phone
- (207) 786-2500
- Fax
- (207) 786-2503
- NPI assigned
- Sep 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janice Fournier, CMPE
- Title
- Practice Administrator
- Phone
- (207) 786-1917
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 015596 | ME | Primary |
Addresses
Primary practice location
475 Lisbon St
Lewiston, ME 04240-7418
Mailing address
193 Main St
Riverside Eye Center
Norway, ME 04268-5645
Phone (207) 743-0027
Other practice location 1
193 Main St
Riverside Eye Center
Norway, ME 04268-5645
Phone (207) 743-0027
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00184354 | Other | RAILROAD MEDICARE | |
| 061139 | Other | ANTHEM | |
| 325120099 | Medicaid | ME | |
| 431545400 | Medicaid | ME | |
| NX3033 | Other | MEDICARE PTAN | |
| M2307901 | Other | CIGNA | |
| MM8909 | Other | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
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 DirectoryLocations
475 Lisbon St
Lewiston, ME 04240
Phone (207) 786-1920
193 Main St
Ste 8
Norway, ME 04268
820 Main St
Berlin, NH 03570
Phone (603) 752-3510
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Portland, ME
- NPI 1043459100
-
- Optometrist
- Auburn, ME
- NPI 1518410133
-
- Ophthalmology Physician
- Norway, ME
- NPI 1003805995
-
- Optometrist
- Aubrun, ME
- NPI 1649476698
-
- Physician Assistant
- Kingfield, ME
- NPI 1811208887
-
- Optometrist
- Norway, ME
- NPI 1164737698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691539200000",
"number": "1780879510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 MAIN ST",
"address_2": "RIVERSIDE EYE CENTER",
"city": "NORWAY",
"state": "ME",
"postal_code": "042685645",
"telephone_number": "207-743-0027",
"fax_number": "207-743-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 LISBON ST",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407418",
"telephone_number": "207-786-2500",
"fax_number": "207-786-2503"
}
],
"practiceLocations": [
{
"address_1": "193 Main St",
"address_2": "Riverside Eye Center",
"address_purpose": "LOCATION",
"city": "Norway",
"state": "ME",
"postal_code": "042685645",
"country_code": "US",
"telephone_number": "207-743-0027",
"fax_number": "207-743-0051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "RIVERSIDE EYE CENTER PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-14",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A",
"authorized_official_last_name": "FOURNIER",
"authorized_official_first_name": "JANICE",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "207-786-1917",
"authorized_official_credential": "CMPE"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "ME",
"license": "015596",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00184354",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "061139",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "325120099",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "431545400",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "NX3033",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "M2307901",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "MM8909",
"state": null
}
],
"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 Aug 9, 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.