Individual provider Active NPI

Abigail Rose Carr

  • Optometrist
  • Lewiston, ME
National Provider Identifier
1467010504
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1015 Issued in ME
Practice address
168 East Ave
Lewiston, ME 04240-5626
Phone
(207) 784-3564
Fax
(207) 782-2541
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometric Associates PA 4 clinicians

Practice addresses (Care Compare)

168 E Ave
Lewiston, ME 04240-5626
Phone 2077843564106

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190726000480 ME Practitioner - Optometry 5799011847 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14478468MEMDOptometrist
OPT1015MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates PA Optometrist CurrentSince Aug 3, 2020 Accepting new patients
Atlee Optical Inc PastSince Jul 15, 2019 Accepting new patients

Locations

168 East Ave
Lewiston, ME 04240
Phone (207) 784-3564

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14478468 ME
Optometrist 152W00000X OPT1015 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

168 East Ave
Lewiston, ME 04240-5626

Mailing address

168 East Ave
Lewiston, ME 04240-5626
Phone (207) 784-3564

Other names 1

NPPES NPI Registry
  • Abigail Rose Heroth Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2023.

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1467010504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 EAST AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405626",
            "telephone_number": "207-784-3564",
            "fax_number": "207-782-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 EAST AVE",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405626",
            "telephone_number": "207-784-3564",
            "fax_number": "207-782-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "14478468",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT1015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "HEROTH",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.