EYECARE MEDICAL GROUP OPTICAL SHOP (NPI# 1184729915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184729915 |
| Entity Type | Organization |
| Organization Name | EYECARE MEDICAL GROUP OPTICAL SHOP |
| Practice Address |
53 Sewall Street Portland ME 04102 |
| Practice Telephone | 2078282020 |
| Practice Fax Number | 2077737034 |
| Mailing Telephone | 2077739597 |
| Mailing Fax Number | 2077737034 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-09-07 |
| Authorized Official Name | MR. CLEMENT M BERRY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2078282020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 109280300 | 05 |
| Street Address |
53 SEWALL STREET |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376599381 | Eyecare Medical Group | Clinic/Center | 53 Sewall Street, Portland, ME 04102-2625 | 2006-05-25 |
| 1467557280 | Eyecare Medical Group | Ophthalmology | 53 Sewall Street, Portland, ME 04102 | 2006-09-14 |
| 1003910126 | Scott M Steidl | Ophthalmology | 53 Sewall Street, Portland, ME 04102-2625 | 2006-09-11 |
| 1386651479 | Jordan Eric Sterrer | Ophthalmology | 53 Sewall Street, Portland, ME 04102 | 2006-08-01 |
| 1326094533 | Jackie K Nguyen | Ophthalmology | 53 Sewall Street, Portland, ME 04102 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573914 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 513-515 Warren Avenue, Portland, ME 04103-1005 | 2020-09-21 |
| 1518473297 | Asterix Eyewear | Eyewear Supplier (Equipment, not the service) | 4936 Se Foster Rd, Portland, OR 97206-3037 | 2017-12-18 |
| 1831616929 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 817 Nw 23rd Ave, Portland, OR 97210-3003 | 2017-08-29 |
| 1568993988 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 9300 Sw Washington Square Rd, Portland, OR 97223-4428 | 2017-03-27 |
| 1063681617 | Oregon Eye Specialists PC | Eyewear Supplier (Equipment, not the service) | 5050 Ne Hoyt St Ste 445, Portland, OR 97213-2984 | 2008-02-28 |
| 1235337890 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 17311 Ne Halsey St, Portland, OR 97230-6025 | 2007-07-05 |
| 1225158496 | Anh Bui | Eyewear Supplier (Equipment, not the service) | 5845 Ne Prescott St, Portland, OR 97218-2231 | 2007-03-30 |
| 1023135670 | Robert M Barton Jr Od | Eyewear Supplier (Equipment, not the service) | 1540 Wildcat Dr, Ste A, Portland, TX 78374-2814 | 2007-03-26 |
| 1831243278 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 513-515 Warren Ave, Portland, ME 04103 | 2007-01-23 |
| 1114076809 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1260 Lloyd Ctr, Portland, OR 97232-1301 | 2007-01-10 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.