Joseph A Damico, OD
Individual provider Active NPI Optometrist · Holden, MA
NPI 1922074590 · NPPES record last updated Nov 22, 2010
Key facts
- NPI
- 1922074590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2112 (MA)
- Practice address
- 1355 Main St
Holden, MA 01520-0041 - Phone
- (508) 829-6731
- Fax
- (508) 829-6732
- NPI assigned
- Feb 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2112 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye-Konic Vision Associates, PLLC | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2112 | MA | Yes |
Addresses
Primary practice location
1355 Main St
Holden, MA 01520-0041
Mailing address
PO Box 41
Holden, MA 01520-0041
Phone (508) 829-6731
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0303909 | Medicaid | MA |
Other providers in Holden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.