Kaco Ocular Prosthetics LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

KACO OCULAR PROSTHETICS LLC

Practice address

1628 McKusick LN
Stillwater, MN 55082-4620

Phone

(978) 239-8821

Fax

(859) 217-6178

NPI assigned

Jul 18, 2022

Organization subpart

No

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

Authorized official

Name

Kevin G. Comeau

Title

Cfo

Phone

(978) 239-8821

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1356076970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 MCKUSICK LN",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 MCKUSICK LN",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824620",
            "telephone_number": "978-239-8821",
            "fax_number": "859-217-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KACO OCULAR PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "COMEAU",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "978-239-8821"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven D Johnson, MD
• Robert C Jones, LADC
• Hannah Lynn Jonson
• Anne Joubert, MSECCCSLP
• Kaco Consultants LLC
• Lena Marie Kaehne
• Ingrid Bwahama Kaijage, M.D.
• Kristen M Kajewski, DO
• Stephanie Summer Kalliman
• Lance Kansas, MD

• Customized Equipment (DME) in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Customized Equipment (DME) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.