Individual provider Active NPI

Susan A. Thomas, MD

  • Family Medicine Physician
  • Lewiston, ME
National Provider Identifier
1821215658
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD13148 Issued in ME
Practice address
12 High St
Ste 302
Lewiston, ME 04240-7634
Phone
(207) 795-5750
Fax
(207) 795-5649
NPI assigned
Apr 20, 2007
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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 MD13148 ME Primary

Addresses

Primary practice location

12 High St
Ste 302
Lewiston, ME 04240-7634

Mailing address

12 High St
Ste 302
Lewiston, ME 04240-7634
Phone (207) 795-5750

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
I20050627000619 ME Practitioner - Family Practice 9234174541 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13148MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Jul 18, 2010 Accepting new patients
Central Maine Medical Center CurrentSince Jul 18, 2010 Accepting new patients

Locations

12 High St
Ste 300
Lewiston, ME 04240
Phone (207) 795-5700

12 High St
Ste 302
Lewiston, ME 04240
Phone (207) 795-5730

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1821215658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE 302",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407634",
            "telephone_number": "207-795-5750",
            "fax_number": "207-795-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST",
            "address_2": "STE 302",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407634",
            "telephone_number": "207-795-5750",
            "fax_number": "207-795-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD13148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.