York Family Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT729 Issued in ME

Legal business name

YORK FAMILY EYECARE

Practice address

764 US Route 1
York, ME 03909-5883

Phone

(207) 363-7555

Fax

(207) 363-1711

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sammy Lee Pelletier, ODNPI 1609841360

Title

President

Phone

(207) 363-7555

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in ME2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• Direct secure messaging: sammy@yorkfamilyeyecare.eyefinity-direct.com

Practitioners 1

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

• Sammy L Pelletier, OD

  • Optometrist
  • York, ME
  • NPI 1609841360
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1295918233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 US ROUTE 1",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039095883",
            "telephone_number": "207-363-7555",
            "fax_number": "207-363-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 US ROUTE 1",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039095883",
            "telephone_number": "207-363-7555",
            "fax_number": "207-363-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YORK FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "PELLETIER",
        "authorized_official_first_name": "SAMMY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-363-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAR #",
            "identifier": "018152",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MNT038",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MM6681",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "09Y000292ME01",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130570000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "M22891",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2237986",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "5021708",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen K. Yavarow, D.O.
• Audrey J Yeaton, LCSW
• York Ambulance Association, Inc.
• York Center for Child Development, LLC
• York Family Dental
• York Family Practice
• York Family Psychiatry LLC
• York Hospital
• York Hospital
• York Hospital

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.