Macario F. Lichauco, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

35149711 Issued in OH

Practice address

489 State St
Kelly 6 Eastern Maine Medical Center
Bangor, ME 04401-6616

Phone

(207) 973-8670

Fax

(207) 973-5163

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pediatric Academic Association, Inc.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1063419943
  Medicare reassignment NPD
• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD (past)
• The Whalen Clinic

  • Orthopaedic Surgery Physician
  • Machias, ME
  • NPI 1700873031
  NPD (past)
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1821026055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "address_2": "KELLY 6 EASTERN MAINE MEDICAL CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-8670",
            "fax_number": "207-973-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "address_2": "KELLY 6 EASTERN MAINE MEDICAL CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-8670",
            "fax_number": "207-973-5163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Glessner Ave",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449032269",
            "country_code": "US",
            "telephone_number": "419-526-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHAUCO",
        "first_name": "MACARIO",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35149711",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "ME",
            "license": "015508",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35149711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033779",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fang Li
• Rung-CHI Li, D.O., PH.D.
• Christanna Harlow Libby, LCPC
• Glynnis R Libby, LSW
• Melissa Lynn Libby, CNM
• Life Lessons Psychiatric Services, SC
• Lifeflight of Maine, LLC
• Sarah Lifer
• Lifeworks of Maine LLC
• Susan Lind, CRNA

• Hospitalist Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Hospitalist Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.

Verify at the official NPI Registry.