NPIMap

Organization Active NPI

Eye Institute of the Merrimack Valley Inc

  • Ambulatory Surgical Clinic/Center
  • Lawrence, MA
National Provider Identifier
1073681714
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EYE INSTITUTE OF THE MERRIMACK VALLEY INC
Practice address
280 Haverhill St
Lawrence, MA 01840
Phone
(978) 685-5366
Fax
(978) 685-4867
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kenneth L Macoul, MDNPI 1891863528
Title
Owner
Phone
(978) 685-5366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X MA Primary

Addresses

Primary practice location

280 Haverhill St
Lawrence, MA 01840

Mailing address

280 Haverhill Street
Lawrence, MA 01840
Phone (978) 685-5366

Other identifiers 1

IdentifierTypeStateIssuer
1850032MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1073681714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HAVERHILL STREET",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-685-5366",
            "fax_number": "978-685-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-685-5366",
            "fax_number": "978-685-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE INSTITUTE OF THE MERRIMACK VALLEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "MACOUL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-685-5366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1850032",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.