Individual provider Active NPI

Justin Marcus Buckley Taylor, MD

  • Family Medicine Physician
  • Auburn, ME
National Provider Identifier
1801645528
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD27904 Issued in ME
Practice address
789 Minot Ave
Auburn, ME 04210-3924
Phone
(207) 795-8475
NPI assigned
May 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD27904 ME Primary

Addresses

Primary practice location

789 Minot Ave
Auburn, ME 04210-3924

Mailing address

625 Post Oak Dr
Coppell, TX 75019-2460
Phone (682) 330-9983

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
I20240722001363 ME Practitioner - Family Practice 2264978626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

789 Minot Ave
Auburn, ME 04210-3924
Phone (207) 795-8475

Hospital & facility affiliations

  • Andwell Health Partners Home health agency, Lewiston, ME, CCN 207019
  • Central Maine Medical Center Hospital, Lewiston, ME, CCN 200024
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Central Maine Medical Center Current Accepting new patients
Central Maine Medical Center CurrentSince Aug 1, 2024 Accepting new patients

Locations

789 Minot Ave
Auburn, ME 04210
Phone (207) 795-8475

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1801645528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 POST OAK DR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192460",
            "telephone_number": "682-330-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103924",
            "telephone_number": "207-795-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JUSTIN",
        "middle_name": "MARCUS BUCKLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD27904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.