BOSTON OCULAR PROSTHETICS INC (NPI# 1659370526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659370526 |
| Entity Type | Organization |
| Organization Name | BOSTON OCULAR PROSTHETICS INC |
| Practice Address |
133 Mortland Rd Searsport ME 04974-0245 |
| Mailing Address |
Po Box 245 Searsport ME 04974-0245 |
| Practice Telephone | 2073525001 |
| Practice Fax Number | 8778242413 |
| Mailing Telephone | 8008242492 |
| Mailing Fax Number | 8778242413 |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2020-05-06 |
| Authorized Official Name | KAYLEE LIZABETH DOUGHERTY (PRESIDENT) |
| Authorized Official Telephone | 8008242492 |
| Authorized Official Credential | BCO, CCA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1700X |
Technician/Technologist Specialization: Ocularist |
Eye and Vision Services Providers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | NO LICENSE REQUI | ME | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 229N00000X | Anaplastologist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 122680000 | 05 | |
| ME | ANTHEM INC MAINE | 005563 | 01 |
| MA | TUFTS | 802828 | 01 |
| ME | CIGNA | M20271 | 01 |
| NH | 30002787 | 05 | |
| ME | AETNA | 0597722 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982106548 | Boston Ocular Prosthetics Inc | Technician/Technologist | 15 Lowell St, Portland, ME 04102-2726 | 2018-02-28 |
| 1124250899 | Boston Ocular Prosthetics Inc | Technician/Technologist | 270 Main St, Reading, MA 01867-3610 | 2009-08-14 |
| Street Address |
133 MORTLAND RD |
| City | SEARSPORT |
| State | ME |
| Zip Code | 04974-0245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548738776 | Kaylee Lizabeth Dougherty | Technician/Technologist | 133 Mortland Rd, Searsport, ME 04974-3337 | 2018-11-06 |
| 1730125600 | Marc W. Goodhart | Social Worker | 133 Mortland Rd, Searsport, ME 04974-3337 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366927287 | Sherry Anne Dunbar | Case Manager/Care Coordinator | 99 Back Searsport Rd, Searsport, ME 04974 | 2018-09-26 |
| 1427112713 | Bethany Jo Mitchell | Social Worker | 11 Cobb Rd, Searsport, ME 04974 | 2006-12-20 |
| 1417028945 | Loren D. Baldus, D.m.d., P.a. | Dentist | #9 Mt. Ephraim Road, Searsport, ME 04974 | 2006-11-13 |
| 1417926163 | Jane Eagles | Counselor | 24 Mortland Road, Searsport, ME 04974 | 2006-03-15 |
| 1851856397 | Lashelbraycm | Community/Behavioral Health | 99 Back Searsport Rd, Searsport, ME 04974 | 2019-02-08 |
| 1700321668 | Athena Bennett | Social Worker | 30 Mortland Rd, Searsport, ME 04974 | 2017-01-03 |
| 1326403569 | Dltc Healthcare LLC | Assisted Living Facility | 45 West Main St, Searsport, ME 04974 | 2015-12-15 |
| 1295113884 | Regional School Unit #71 | Specialist | 6a Lions Way, 98 Waldo Ave., Belfast, ME 04974 | 2015-05-14 |
| 1528603677 | Mackenzie Rose Clapp | Dietitian, Registered | 49 E Main St, Apartment B, Searsport, ME 04974-0258 | 2019-11-13 |
| 1750453288 | Loren D. Baldus | Dentist | #9 Mt. Ephraim Road, Searsport, ME 04974-0327 | 2006-11-13 |
| Find all providers in zip 04974 | ||||
| Taxonomy Code | 229N00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Anaplastologist |
| An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). |
| Notes: Source: American Anaplastology Association, www.anaplastology.org. [7/1/2006: new] |
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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.