Individual provider Active NPI

Emily Ketch, OD

  • Optometrist
  • Brewer, ME
National Provider Identifier
1376476028
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1117 Issued in ME
Practice address
15 Dirigo Dr
Brewer, ME 04412-1600
Phone
(207) 945-5891
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT1117 ME Primary

Addresses

Primary practice location

15 Dirigo Dr
Brewer, ME 04412-1600

Mailing address

15 Dirigo Dr
Brewer, ME 04412-1600

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 Dirigo Dr
Suite 1
Brewer, ME 04412-1600

3768 Waterton Dr
Grandville, MI 49418-8612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT1117MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SJV, PLLC Optometrist CurrentSince Jun 28, 2026 Accepting new patients

Locations

15 Dirigo Dr
Brewer, ME 04412
Phone (207) 945-5891

Organizations & group practices 1

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": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1376476028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DIRIGO DR",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DIRIGO DR",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121600",
            "telephone_number": "207-945-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCH",
        "first_name": "EMILY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT1117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

Verify at the official NPI Registry.