| Cecilia K Trydestam, MD | |
|
93 Campus Ave I2 Wing, Lewiston, ME 04240 | |
| (207) 777-8650 | |
| (207) 777-8641 |
| Full Name | Cecilia K Trydestam |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 16 Years |
| Location | 93 Campus Ave I2 Wing, Lewiston, Maine |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811121684 | NPI | - | NPPES |
| 1811121684 | Medicaid | WA | |
| P01625698 | Other | WA | RR MEDICARE WVH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD60458584 (Washington) | Secondary |
| 208600000X | Surgery | MD24297 (Maine) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Waldo County General Hospital | Belfast, ME | Hospital |
| St Mary's Regional Medical Center | Lewiston, ME | Hospital |
| Penobscot Bay Medical Center | Rockport, ME | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Marys Regional Medical Center | 0042107120 | 178 |
| Mainehealth | 7517860588 | 2288 |
| Entity Name | St Marys Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447226584 PECOS PAC ID: 0042107120 Enrollment ID: O20040303000236 |
| Entity Name | Maine Medical Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285738310 PECOS PAC ID: 9335043967 Enrollment ID: O20040525000396 |
| Entity Name | Mainehealth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
| Mailing Address | Practice Location Address |
|---|---|
| Cecilia K Trydestam, MD 770 Roosevelt Trail, Ste 8 #1015, N Windham, ME 04062 Ph: (207) 717-9550 | Cecilia K Trydestam, MD 93 Campus Ave I2 Wing, Lewiston, ME 04240 Ph: (207) 777-8650 |
David S Lewis, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 12 High St Ste 401, Lewiston, ME 04240 Phone: 207-795-5767 Fax: 207-795-2732 | |
David J Burke, MD Surgery Medicare: Medicare Enrolled Practice Location: 12 High St, Ste. 401, Lewiston, ME 04240 Phone: 207-795-5767 | |
Ms. Marsha C O'rourke, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 99 Campus Ave, Suite 303, Lewiston, ME 04240 Phone: 207-782-5424 Fax: 207-782-1136 | |
Allan M Ingraham, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 60 High St, Cmhvi-y1, Lewiston, ME 04240 Phone: 207-795-8260 Fax: 207-795-8281 | |
George Randolph Tuchsen, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 12 High St Ste 401, Lewiston, ME 04240 Phone: 207-795-5767 | |
Gregory D'augustine, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 10 High St, Suite 202, Lewiston, ME 04240 Phone: 207-784-2903 | |
Dr. Scott Raymond Johnson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 12 High St Ste 401, Lewiston, ME 04240 Phone: 207-795-5767 Fax: 207-795-2732 |