Active NPI
Reginald Mailhot, OD
- Optometrist
- Lewiston, ME
National Provider Identifier
1962458505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT602
- Practice address
- 220 Sabattus St
Lewiston, ME 04240-6347 - Phone
- (207) 782-9501
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT602 | ME | Primary |
Addresses
Primary practice location
220 Sabattus St
Lewiston, ME 04240-6347
Mailing address
220 Sabattus St
Lewiston, ME 04240-6347
Phone (207) 782-9501
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M52420 | Other | ME | CIGNA HEALTHSOURCE # |
| 105560000 | Medicaid | ME | |
| 000023 | Other | ME | ANTHEM ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT602 | ME | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254787200000",
"number": "1962458505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 SABATTUS ST",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042406347",
"telephone_number": "207-782-9501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SABATTUS ST",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042406347",
"telephone_number": "207-782-9501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILHOT",
"first_name": "REGINALD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2009-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ME",
"license": "OPT602",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHSOURCE #",
"identifier": "M52420",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105560000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM ID #",
"identifier": "000023",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.