NPIMap

Organization Active NPI

Smart Vision, LLC

  • Optometrist
  • Farmingdale, ME
National Provider Identifier
1245309400
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT961 Issued in ME
Legal business name
SMART VISION, LLC
Practice address
210 Maine Ave
Farmingdale, ME 04344-4515
Phone
(207) 582-5800
Fax
(207) 588-0743
NPI assigned
Nov 6, 2006
Last updated
Feb 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Jessilin M Quint, O.D.NPI 1841603867
Title
President/Optometrist
Phone
(207) 582-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT961 ME Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

210 Maine Ave
Farmingdale, ME 04344-4515

Mailing address

210 Maine Ave
Farmingdale, ME 04344-4515
Phone (207) 582-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180721000142 ME DME Supplier - Physician - Optometrist 8022393230 Practice locations: Farmingdale, ME

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Smart Vision LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1245309400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MAINE AVE",
            "city": "FARMINGDALE",
            "state": "ME",
            "postal_code": "043444515",
            "telephone_number": "207-582-5800",
            "fax_number": "207-588-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MAINE AVE",
            "city": "FARMINGDALE",
            "state": "ME",
            "postal_code": "043444515",
            "telephone_number": "207-582-5800",
            "fax_number": "207-588-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "QUINT",
        "authorized_official_first_name": "JESSILIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "207-582-5800",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT961",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.