NPIMap

Organization Active NPI

Laconia Eye Associates PA

  • Ophthalmology Physician
  • Gilford, NH
National Provider Identifier
1295875383
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LACONIA EYE ASSOCIATES PA
Practice address
368 Hounsell Ave
Gilford, NH 03249-6922
Phone
(603) 528-2606
Fax
(603) 528-2805
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Dr. Douglas R Scott, MDNPI 1629064639
Title
President
Phone
(603) 528-2606

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 832 NH
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 10993 NH
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 8400 NH
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

368 Hounsell Ave
Gilford, NH 03249-6922

Mailing address

PO Box 7625
Gilford, NH 03247-7625
Phone (603) 528-2606

Other identifiers 1

IdentifierTypeStateIssuer
30212353MedicaidNH

Other names 1

  • dba: Laconia Eye & Laser Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080825000016 NH Part B Supplier - Clinic/Group Practice 7911072038 Receives reassigned benefits from 9 practitioners
Practice locations: Gilford, NH
O20100930042005 NH DME Supplier - Physician - OphthalmologyDME Supplier - Optician 7911072038 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gilford, NH

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

607 Tenney Mountain Hwy
Plymouth, NH 03264
Phone (603) 536-3569

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1295875383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7625",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "032477625",
            "telephone_number": "603-528-2606",
            "fax_number": "603-528-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 HOUNSELL AVE",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "032496922",
            "telephone_number": "603-528-2606",
            "fax_number": "603-528-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACONIA EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-528-2606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NH",
            "license": "832",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NH",
            "license": "10993",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NH",
            "license": "8400",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30212353",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba: Laconia Eye & Laser Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.