| Dr Otoniel David Puerto, MD | |
|
360 Broadway, Bangor, ME 04401 | |
| (207) 907-1430 | |
| (207) 907-3508 |
| Full Name | Dr Otoniel David Puerto |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 38 Years |
| Location | 360 Broadway, Bangor, Maine |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568459667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 34465 (Kentucky) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 34465 (Kentucky) | Secondary |
| 207L00000X | Anesthesiology | MD22859 (Maine) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Joseph London | London, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Commonwealth Anesthesia, Psc | 5092627521 | 194 |
| Entity Name | Commonwealth Anesthesia, Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437196300 PECOS PAC ID: 5092627521 Enrollment ID: O20031104000115 |
| Entity Name | Kentucky Anesthesia Group Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073608634 PECOS PAC ID: 4082527890 Enrollment ID: O20031107000511 |
| Entity Name | Triangle Anesthesia Group, Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124079314 PECOS PAC ID: 9436161585 Enrollment ID: O20060608000180 |
| Entity Name | Northstar Anesthesia Of Kentucky, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386938900 PECOS PAC ID: 8628248069 Enrollment ID: O20110823000443 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Otoniel David Puerto, MD C/o St Marys Health System - Provider Enrollment, Po Box 7291, Lewiston, ME 04243-7291 Ph: (207) 777-8941 | Dr Otoniel David Puerto, MD 360 Broadway, Bangor, ME 04401 Ph: (207) 907-1430 |
Dane Hassani, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 360 Broadway, Bangor, ME 04401 Phone: 207-907-1430 Fax: 207-907-3508 | |
Dr. Dianna Logan Branson, MD ANESTHESIOLOGIST Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 489 State St, Bangor, ME 04401 Phone: 207-973-7000 Fax: 207-973-5042 | |
Kelly A Morgan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 360 Broadway, Bangor, ME 04401 Phone: 207-262-1464 | |
Dr. Catherine Shields, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 489 State St, Bangor, ME 04401 Phone: 207-973-5918 | |
David M. Clement, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 360 Broadway, Bangor, ME 04401 Phone: 207-262-1464 | |
Kishore Anoop Tolani, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 489 State St, Bangor, ME 04401 Phone: 207-973-5918 | |
Haithm A.s. Abdelsalam, M.D Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 489 State St, Bangor, ME 04401 Phone: 207-275-0987 |