Individual provider Active NPI

Steve Richard Witkin, M.D.

  • Ophthalmology Physician
  • Waterville, ME
National Provider Identifier
1790772887
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
012313 Issued in ME
Practice address
325A Kennedy Memorial Dr
Waterville, ME 04901-4517
Phone
(207) 873-2731
Fax
(207) 873-1106
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 012313 ME Primary

Addresses

Primary practice location

325A Kennedy Memorial Dr
Waterville, ME 04901-4517

Mailing address

325A Kennedy Memorial Dr
Waterville, ME 04901-4517
Phone (207) 873-2731

Other identifiers 1

IdentifierTypeStateIssuer
298580099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000802 ME Practitioner - Ophthalmology 3274621834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012313MEMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Eye Care Associates CurrentSince May 22, 1987 Accepting new patients
Maine Eye Care Associates Ophthalmology CurrentSince May 22, 1987 Accepting new patients

Locations

325A Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 667-9690

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1790772887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325A KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014517",
            "telephone_number": "207-873-2731",
            "fax_number": "207-873-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325A KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014517",
            "telephone_number": "207-873-2731",
            "fax_number": "207-873-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKIN",
        "first_name": "STEVE",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "012313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298580099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.