Kenmore Optical

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KENMORE OPTICAL

Practice address

1018 Beacon St Ste 100
Brookline, MA 02446-4058

Phone

(617) 536-7870

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Susan O'Shea, O.D.NPI 1821109703

Title

Owner Optometrist

Phone

(508) 380-8966

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KENMORE OPTICAL Doing business as

Locations

Practitioners 1

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

• Susan Marianne O'Shea, O.D.

  • Optometrist
  • Boston, MA
  • NPI 1821109703
  NPD Authorized official

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1669062113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 BEACON ST STE 100",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 BEACON ST STE 100",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464058",
            "telephone_number": "617-536-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMORE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "O'SHEA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "508-380-8966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821109703",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENMORE OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justine R Kelley, DMD
• Pamela Parkinson Kellogg, MD
• Kelly Miller LLC
• Caitlin Marie Kelly
• Amaura W Kemmerer, LICSW
• Nicole Kennedy, RN
• Kenneth R. Rice, PC
• Anne Kent
• Hope Carolyn Kentala, MS, SLP
• Louise Kenyon

• Primary Care Clinic/Center in Brookline, MA
• Providers in Brookline, MA by specialty
• Primary Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.