Boston Ocular Prosthetics Inc

Primary specialty

AnaplastologistTaxonomy code 229N00000X

Legal business name

BOSTON OCULAR PROSTHETICS INC

Practice address

133 Mortland Rd
Searsport, ME 04974-0245

Phone

(207) 352-5001

Fax

(877) 824-2413

NPI assigned

Jul 21, 2005

Last updated

May 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kaylee Lizabeth Dougherty, BCO, CCANPI 1548738776

Title

President

Phone

(800) 824-2492

Specialties & licenses 4

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Boston Ocular Prosthetics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Boston Ocular Prosthetics Inc

  • Anaplastologist
  • Portland, ME
  • NPI 1982106548
  NPD tax ID
• Boston Ocular Prosthetics Inc

  • Anaplastologist
  • Reading, MA
  • NPI 1124250899
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kaylee Lizabeth Dougherty, BCO, CCA

  • Ocularist
  • Searsport, ME
  • NPI 1548738776
  NPD (past) Authorized official

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1659370526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "SEARSPORT",
            "state": "ME",
            "postal_code": "049740245",
            "telephone_number": "800-824-2492",
            "fax_number": "877-824-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 MORTLAND RD",
            "city": "SEARSPORT",
            "state": "ME",
            "postal_code": "049740245",
            "telephone_number": "207-352-5001",
            "fax_number": "877-824-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON OCULAR PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "KAYLEE",
        "authorized_official_middle_name": "LIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-824-2492",
        "authorized_official_credential": "BCO, CCA"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ME",
            "license": "NO LICENSE REQUIRED",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "229N00000X",
            "taxonomy_group": "",
            "desc": "Anaplastologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INC MAINE",
            "identifier": "005563",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "802828",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122680000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30002787",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M20271",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0597722",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loren D. Baldus, D.M.D.
• Brandy Bracy
• Brock Bayview LLC (Bayview Assisted Living)
• Brock Health Inc
• Susan Bryant, CCC-SLP
• Katherine Charland

• Anaplastologist in Searsport, ME
• Providers in Searsport, ME by specialty
• Anaplastologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.