Individual provider Active NPI

Lindsey Kazanovicz Boyle, BCO

  • Ocularist
  • Bedford, NH
National Provider Identifier
1275068934
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
License
16-375-22 Issued in IA
Practice address
169 S River Rd
14A
Bedford, NH 03110-6971
Phone
(603) 622-5200
Fax
(603) 644-2354
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X 16-375-22 IA Primary

Addresses

Primary practice location

169 S River Rd
14A
Bedford, NH 03110-6971

Mailing address

169 S River Rd
14A
Bedford, NH 03110-6971
Phone (603) 622-5200

Other practice location 1

54 Main St
Sturbridge, MA 01566-1281
Phone (508) 347-3818

Other identifiers 1

IdentifierTypeStateIssuer
16-375-22OtherNHNATIONAL EXAMINING BOARD OF OCULARIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16-375-22IAMDOcularist

Practice roles

OrganizationSpecialtyStatusNew patients
Monoplex Eye Prosthetics, Inc Ocularist Current Accepting new patients
Monoplex Eye Prosthetics Current Accepting new patients

Locations

54 Main St
Sturbridge, MA 01566
Phone (508) 347-3818

169 S River Rd
Unit 14A
Bedford, NH 03110
Phone (603) 622-5200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1275068934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "14A",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971",
            "telephone_number": "603-622-5200",
            "fax_number": "603-644-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "14A",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971",
            "telephone_number": "603-622-5200",
            "fax_number": "603-644-2354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Main St",
            "address_purpose": "LOCATION",
            "city": "Sturbridge",
            "state": "MA",
            "postal_code": "015661281",
            "country_code": "US",
            "telephone_number": "508-347-3818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAZANOVICZ BOYLE",
        "first_name": "LINDSEY",
        "credential": "BCO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-12-11",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "IA",
            "license": "16-375-22",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL EXAMINING BOARD OF OCULARIST",
            "identifier": "16-375-22",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.