Michael Harold Gonyea, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT708 Issued in ME

Practice address

82 Water St
Ellsworth, ME 04605-2006

Phone

(207) 667-8615

Fax

(207) 667-4212

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1851301022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 WATER ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052006",
            "telephone_number": "207-667-8615",
            "fax_number": "207-667-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 WATER ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052006",
            "telephone_number": "207-667-8615",
            "fax_number": "207-667-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONYEA",
        "first_name": "MICHAEL",
        "middle_name": "HAROLD",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "010999",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "522108187534",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410026218",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253160099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1190660001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane E Gerlach, CNM MS
• Ghanem Dental PLLC
• Jody (None) Gillen-Worden, LCSW
• Astor Charlene Gillis, B.S., L.A.D.C.
• Peter R Goebel, MD
• Paul David Goodman, M.D.
• Heather K Gosselin, LCSW
• Jeffrey S Graham, M.D.
• Julie Ann Graham, FNP
• Adam W Grasso, MD

• Optometrist in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.