NPIMap

Organization Active NPI

Eyecare Medical Group

  • Ophthalmology Physician
  • Portland, ME
National Provider Identifier
1831430461
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE MEDICAL GROUP
Practice address
53 Sewall St
Portland, ME 04102-2625
Phone
(207) 828-2020
Fax
(207) 773-7034
NPI assigned
Mar 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Lynn Shorty, RN, CMPE
Title
Chief Operating Officer
Phone
(207) 791-8234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

53 Sewall St
Portland, ME 04102-2625

Mailing address

53 Sewall St
Portland, ME 04102-2625
Phone (207) 828-2020

Other names 1

  • EMG Service Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Medical Group3 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.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1831430461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022625",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022625",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "SHORTY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "207-791-8234",
        "authorized_official_credential": "RN, CMPE"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMG Service Facility",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "EMG Service Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.