Kevin W Shum, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT1014 Issued in ME

Practice address

82 Maine St
Brunswick, ME 04011-2015

Phone

(207) 729-8474

Fax

(207) 729-8955

NPI assigned

Jul 8, 2019

Last updated

Jul 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

New England College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maine Optometry PAGroup PAC ID 8022009117, 23 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevinshum@maineoptometry.eyefinity-direct.com

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

• Maine Optometry PA

  • Optometrist
  • Gorham, ME
  • NPI 1437182383
  Medicare reassignment Care Compare group NPD
• Arthur Chapman III OD PA

  • Optometrist
  • Standish, ME
  • NPI 1700068343
  NPD (past)
• Roger L. Bergeron, O.D.P.a.

  • Eyewear Supplier
  • Lewiston, ME
  • NPI 1629249842
  NPD (past)

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1285296517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 MAINE ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112015",
            "telephone_number": "207-729-8474",
            "fax_number": "207-729-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAINE ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112015",
            "telephone_number": "207-729-8474",
            "fax_number": "207-729-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM",
        "first_name": "KEVIN",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT1014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaws Supermarkets Inc (Shaws Pharmacy #0628)
• Erin Sheets, PH.D.
• Amber Shepherd, FNP-BC
• Ingrid M Sherrill, PA
• Heather Marie Shields, OTR
• Alina Shumsky, PH.D.
• Doreen Muir Siddall, NP
• Charles Sifton, L.AC.
• Silver Birch Counseling LLC
• Leslie Joy Simmons, MA LCPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.