Active NPI
Joseph A Damico, OD
- Optometrist
- Holden, MA
National Provider Identifier
1922074590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2112
- Practice address
- 1355 Main St
Holden, MA 01520-0041 - Phone
- (508) 829-6731
- Fax
- (508) 829-6732
- NPI assigned
- Feb 24, 2006
- Last updated
- Nov 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2112 | MA | Primary |
Addresses
Primary practice location
1355 Main St
Holden, MA 01520-0041
Mailing address
PO Box 41
Holden, MA 01520-0041
Phone (508) 829-6731
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1922074590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 41",
"city": "HOLDEN",
"state": "MA",
"postal_code": "015200041",
"telephone_number": "508-829-6731",
"fax_number": "508-829-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 MAIN ST",
"city": "HOLDEN",
"state": "MA",
"postal_code": "015200041",
"telephone_number": "508-829-6731",
"fax_number": "508-829-6732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMICO",
"first_name": "JOSEPH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "2112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Holden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.