Jack Waterman (NPI# 1356452171, PAC ID# 1759364185) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1356452171 |
| PAC ID by PECOS | 1759364185 |
| Professional Enrollment ID | I20040608000920 |
| Full Name | Jack Waterman |
| Organization Legal Name | PENOBSCOT BAY PHYSICIANS AND ASSOCIATES |
| Address |
3 Glen Cove Dr Rockport ME 04856-4232 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 1977 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 4981592383 |
| Number of Group Practice Members | 86 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 200063 | PENOBSCOT BAY MEDICAL CENTER |
| 201302 | ST ANDREWS HOSPITAL |
| 200039 | MAINEGENERAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3 Glen Cove Dr, Rockport, ME 04856-4232 | PENOBSCOT BAY PHYSICIANS AND ASSOCIATES |
| Organization Legal Name | PENOBSCOT BAY PHYSICIANS AND ASSOCIATES |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marie Ilvonen | Clinical Social Worker | Penobscot Bay Physicians and Associates | 27 Mill St, Waldoboro, ME 04572-6013 |
| David A Bradeen | Internal Medicine | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Richard J Kahn | Internal Medicine | Penobscot Bay Physicians and Associates | 30 Community Dr, Camden, ME 04843-2061 |
| Gerald F Westover | Internal Medicine | Penobscot Bay Physicians and Associates | 6 Glen Cove Dr, Rockport, ME 04856-4273 |
| Joseph D Pandiscia | Physician Assistant | Penobscot Bay Physicians and Associates | 4 Glen Cove Dr, Rockport, ME 04856-4239 |
| Omer A Thibodeau | General Surgery | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Lori K Jackson | Physician Assistant | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Kimberly Sigworth | Nurse Practitioner | Penobscot Bay Physicians and Associates | 4 Glen Cove Dr, Suite 202, Rockport, ME 04856-4238 |
| William E Master | Infectious Disease | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Susan L Bell | Nurse Practitioner | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Street Address |
3 GLEN COVE DR |
| City | ROCKPORT |
| State | ME |
| Zip | 04856-4232 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David A Bradeen | Internal Medicine | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Omer A Thibodeau | General Surgery | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Lori K Jackson | Physician Assistant | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| William E Master | Infectious Disease | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Susan L Bell | Nurse Practitioner | Penobscot Bay Physicians and Associates | 3 Glen Cove Dr, Rockport, ME 04856-4232 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Howard W Hoyt | Ophthalmology | Hoyt Eye Care Center, LLC | 1100 Commercial St, Rockport, ME 04856-3801 |
| Lynne Kaplinsky | Ophthalmology | Hoyt Eye Care Center, LLC | 1100 Commercial St, Rockport, ME 04856-3801 |
| Allan J Bogdan | Ophthalmology | 34 Old County Rd, Rockport, ME 04856-4004 | |
| Robert J Dreher | Ophthalmology | 34 Old County Rd, Rockport, ME 04856-4004 | |
| Clyde A Watkins Jr. | Psychiatry | Penobscot Bay Medical Center | 756 Commercial St, Rockport, ME 04856-4201 |
| Chris J Michalakes | Emergency Medicine | Penobscot Bay Medical Center | 756 Commercial St, Rockport, ME 04856-4201 |
| Andrew E Filderman | Pulmonary Disease | 4 Glen Cove Dr, Suite 107, Rockport, ME 04856-4236 | |
| Mark A Billington | General Surgery | Mainehealth | 4 Glen Cove Dr, Suite 103, Rockport, ME 04856-4236 |
| Sally E Kirkpatrick | Neurology | Mainehealth | 4 Glen Cove Dr, Suite 102, Rockport, ME 04856-4236 |
| Thomas E Crosslin | General Surgery | Mainehealth | 4 Glen Cove Dr, Suite 103, Rockport, ME 04856-4236 |
| Find all physicians in zip 04856 | |||
| City | ROCKPORT |
| Zip Code | 04856 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | ROCKPORT + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Jack Waterman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.