Individual provider Active NPI

Steven Paul Lary, OD

  • Optometrist
  • Portland, ME
National Provider Identifier
1649351552
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT682 Issued in ME
Practice address
1039 Washington Ave
Portland, ME 04103-3628
Phone
(207) 775-6533
Fax
(207) 775-2702
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT682 ME Primary

Addresses

Primary practice location

1039 Washington Ave
Portland, ME 04103-3628

Mailing address

24 Mica CT
Topsham, ME 04086-1776
Phone (207) 557-5996

Other identifiers 1

IdentifierTypeStateIssuer
126090000MedicaidME

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
I20050630000896 ME Practitioner - Optometry 7517937014 Reassigns benefits to 3 organizations
Receives reassigned benefits from 2 practitioners
Practice locations: Camden, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT682MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Hills Eye Care LLC Optometrist CurrentSince Mar 1, 2018 Accepting new patients
Tracy K Giles PA Optometrist CurrentSince Mar 23, 2021 Accepting new patients

Locations

38 Curtis Ave
Camden, ME 04843
Phone (207) 236-3300

1039 Washington Ave
Portland, ME 04103
Phone (207) 775-6533

Practitioners & affiliated clinicians

Practitioners 2

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

Organizations & group practices 3

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1649351552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MICA CT",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861776",
            "telephone_number": "207-557-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033628",
            "telephone_number": "207-775-6533",
            "fax_number": "207-775-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARY",
        "first_name": "STEVEN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126090000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.