Active NPI
Martin David Kass, OPTICIAN
- Optician
- Plymouth, NH
National Provider Identifier
1902930258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 014
- Practice address
- 607 Tenney Mountain Hwy
Plymouth, NH 03264-3156 - Phone
- (603) 536-3569
- Fax
- (603) 536-3654
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 014 | NH | Primary |
Addresses
Primary practice location
607 Tenney Mountain Hwy
Plymouth, NH 03264-3156
Mailing address
607 Tenney Mountain Hwy
Plymouth, NH 03264-3156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30003865 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014 | NH | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plymouth Optical | Optician | Current | Accepting new patients |
Locations
607 Tenney Mountain Hwy
Plymouth, NH 03264
Phone (603) 536-3569
Organizations & group practices 1
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": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1902930258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 TENNEY MOUNTAIN HWY",
"city": "PLYMOUTH",
"state": "NH",
"postal_code": "032643156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 TENNEY MOUNTAIN HWY",
"city": "PLYMOUTH",
"state": "NH",
"postal_code": "032643156",
"telephone_number": "603-536-3569",
"fax_number": "603-536-3654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASS",
"first_name": "MARTIN",
"middle_name": "DAVID",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NH",
"license": "014",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30003865",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.