Stephen Lewis Ebersole, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT832TA6 Issued in ME

Practice address

168 East Ave
Optometric Associates
Lewiston, ME 04240

Phone

(207) 784-3564

Fax

(207) 782-2541

NPI assigned

Jun 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optometric Associates PAGroup PAC ID 2264400068, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optometric Associates PA

  • Optometrist
  • Lewiston, ME
  • NPI 1205038544
  Medicare reassignment Care Compare group NPD
• Vision Care of Maine LLC

  • Ambulatory Surgical Clinic/Center
  • Bangor, ME
  • NPI 1275629081
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1235174889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 EAST AVE",
            "address_2": "OPTOMERIC ASSOCIATES PA",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405626",
            "telephone_number": "207-784-3564",
            "fax_number": "207-782-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 EAST AVE",
            "address_2": "OPTOMETRIC ASSOCIATES",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-784-3564",
            "fax_number": "207-782-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "STEPHEN",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "832TA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT832TA6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313250099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Duval
• Joseph M Earnhardt, MSNA, RN, CRNA
• Nicole Easterby, LMSW-CC
• Katherine Eaton, M.D.
• Ebbing Tides Counseling Services LLC
• Echo Residentia LLC
• Misty Edgecomb, LMT
• Ashley Edwards, MS, RD, LD
• Nina K. Edwards, MD.
• Maria Egger, PA-C

• Optometrist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.