Individual provider Active NPI

Jeffrey A Stone, D.O.

  • Pediatrics Physician
  • Waterville, ME
National Provider Identifier
1891799649
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1317 Issued in ME
Practice address
295C Kennedy Memorial Dr Ste 1
Waterville, ME 04901-4535
Phone
(207) 873-5437
Fax
(207) 872-6037
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1317 ME Primary

Addresses

Primary practice location

295C Kennedy Memorial Dr Ste 1
Waterville, ME 04901-4535

Mailing address

295C Kennedy Memorial Dr Ste 1
Waterville, ME 04901-4535
Phone (207) 873-5437

Other identifiers 1

IdentifierTypeStateIssuer
124310099MedicaidME

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
I20130110000198 ME Practitioner - Pediatric Medicine 9830342443 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jan 18, 2026 Accepting new patients
Eastern Maine Medical Center CurrentSince Jan 18, 2026 Accepting new patients
Waterville Pediatrics PA Pediatrics Past Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

133 Corporate Dr
Bangor, ME 04401
Phone (207) 941-1155

200 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 861-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1891799649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295C KENNEDY MEMORIAL DR STE 1",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014535",
            "telephone_number": "207-873-5437",
            "fax_number": "207-872-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295C KENNEDY MEMORIAL DR STE 1",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014535",
            "telephone_number": "207-873-5437",
            "fax_number": "207-872-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "1317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124310099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.