EYECARE MEDICAL GROUP (NPI# 1376599381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376599381 |
| Entity Type | Organization |
| Organization Name | EYECARE MEDICAL GROUP |
| Practice Address |
53 Sewall Street Portland ME 04102-2625 |
| Practice Telephone | 2078282020 |
| Practice Fax Number | 2077737034 |
| Mailing Telephone | 2078282020 |
| Mailing Fax Number | 2077737034 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | 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 | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
36395 | ME | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 109280100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831430461 | Eyecare Medical Group | Ophthalmology | 53 Sewall St, Portland, ME 04102-2625 | 2013-03-06 |
| 1467557280 | Eyecare Medical Group | Ophthalmology | 53 Sewall Street, Portland, ME 04102 | 2006-09-14 |
| Street Address |
53 SEWALL STREET |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-2625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184729915 | Eyecare Medical Group Optical Shop | Eyewear Supplier (Equipment, not the service) | 53 Sewall Street, Portland, ME 04102 | 2006-09-14 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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| 1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
| 1780959007 | Columbia River Surgery Center LLC | Clinic/Center | 9820 Ne Cascades Pkwy, Portland, OR 97220-6825 | 2012-03-20 |
| 1245471788 | Pacific Cataract and Laser Institute Inc PC | Clinic/Center | 1331 Nw Lovejoy Street, Suite 750, Portland, OR 97209 | 2009-03-12 |
| 1518022615 | Futures Outpatient Surgical Center | Clinic/Center | 1849 Nw Kearney St Ste 302, Portland, OR 97209-1453 | 2006-12-27 |
| 1245336411 | Lovejoy Surgicenter Inc. | Clinic/Center | 933 Nw 25th Ave, Portland, OR 97210-2829 | 2006-09-15 |
| 1710992680 | Ambulatory Surgical Center | Clinic/Center | 10201 Se Main St Ste 20, Portland, OR 97216-2937 | 2006-07-29 |
| 1609896539 | Cedar Hills Ambulatory Surgery Center LLC | Clinic/Center | 10305 Sw Park Way Ste 101, Portland, OR 97225-5033 | 2006-07-21 |
| 1518382936 | Spectrum Healthcare Partners, P.a | Clinic/Center | 33 Sewall St, Portland, ME 04102-2603 | 2014-02-21 |
| 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.