Individual provider Active NPI

Juliann Kandra, O.D.

  • Optometrist
  • Saco, ME
National Provider Identifier
1669469052
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT967 Issued in ME
Practice address
323 Main St
Saco, ME 04072-1514
Phone
(207) 284-4560
Fax
(207) 283-0309
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT967 ME Primary

Addresses

Primary practice location

323 Main St
Saco, ME 04072-1514

Mailing address

323 Main St
Saco, ME 04072-1514
Phone (207) 284-4560

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
I20160205000653 ME Practitioner - Optometry 2062484090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

323 Main St
Saco, ME 04072-1514
Phone (207) 284-4560

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1047AZMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Juliann Kandra, OD, PC Optometrist CurrentSince Dec 7, 2015 Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients

Locations

323 Main St
Saco, ME 04072
Phone (207) 284-4560

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1669469052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MAIN ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721514",
            "telephone_number": "207-284-4560",
            "fax_number": "207-283-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MAIN ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721514",
            "telephone_number": "207-284-4560",
            "fax_number": "207-283-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDRA",
        "first_name": "JULIANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.