Kennebec Eyecare PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KENNEBEC EYECARE PA

Practice address

216 Main St
Waterville, ME 04901-6116

Phone

(207) 872-2797

Fax

(207) 872-2793

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Peter Paradis, ODNPI 1912900309

Title

Owner

Phone

(207) 872-2797

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME2 enrollments

Enrollment records 2

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

Locations

Practitioners 8

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

• Peter Douglas Paradis, O.D.

  • Optometrist
  • Waterville, ME
  • NPI 1912900309
  Medicare reassignment Care Compare group NPD Authorized official
• Kaylee Brann

  • Optometrist
  • Waterville, ME
  • NPI 1255184198
  Medicare reassignment Care Compare group NPD
• Lesley Ann Sobeck, O.D.

  • Optometrist
  • Augusta, ME
  • NPI 1720243744
  Medicare reassignment Care Compare group NPD
• Laura Katherine Dowd, O.D

  • Optometrist
  • Augusta, ME
  • NPI 1255567467
  Medicare reassignment NPD
• David Joseph Benes, O.D.

  • Optometrist
  • Bangor, ME
  • NPI 1487768453
  NPD (past)
• Ryan M Hogan, OD

  • Optometrist
  • Waterville, ME
  • NPI 1629180120
  NPD (past)
• Rochelle Jessica Hudson, O,D,

  • Optometrist
  • Waterville, ME
  • NPI 1063469195
  NPD (past)
• Anthony M Lee, OD

  • Optometrist
  • Waterville, ME
  • NPI 1851491732
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1659462067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016116",
            "telephone_number": "207-872-2797",
            "fax_number": "207-872-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016116",
            "telephone_number": "207-872-2797",
            "fax_number": "207-872-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC EYECARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "PARADIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-872-2797",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127280001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Kelleher, P.T.
• Chandler Kelley
• Brandon Kelly
• Monica L. Kelly, LCSW
• Linda Keniston, MD
• Kennebec Medical Associates, P.a.
• Kennebec Medical Consultants LLC
• Kennebec Valley Community Action Program
• Kennebec Valley Community Action Program
• Kennebec Valley Community Action Program (KVCAP Healthy Families)

• Optometrist in Waterville, ME
• Providers in Waterville, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.