Stephen P. Holmes Jr., O.D.
Individual provider Active NPI Optometrist · Sandwich, MA
NPI 1962439752 · NPPES record last updated Jun 5, 2012
Key facts
- NPI
- 1962439752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- MA3514 (MA)
- Practice address
- 68 Tupper Rd
Merchant'S Square
Sandwich, MA 02563-1872 - Phone
- (508) 888-3800
- Fax
- (508) 888-3821
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
68 Tupper Rd
Suite 9
Sandwich, MA 02563-0537
Phone (508) 888-3800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120604000317 | MA | Practitioner - Optometry | 4587786553 | Practice locations: Buzzards Bay, MA; Sandwich, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA3514 | MA | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | MA3514 | MA | Yes |
Addresses
Primary practice location
68 Tupper Rd
Merchant'S Square
Sandwich, MA 02563-1872
Mailing address
68 Tupper Rd
P.O. Box 537
Sandwich, MA 02563-1872
Phone (508) 888-3800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0393649 | Medicaid | MA | |
| W15833 | Other | MA | BLUE CROSS |
Other providers in Sandwich, MA
- Steven R. Harris
- Megan Harrop
- Jasmine Heggs
- Heritage Medical Group Inc.
- Benjamin Stillman Hixon
- Home Instead Senior Care
- Mary Elizabeth Horton
- Inner Alchemy Counseling, LLC
- Emmanuel Iskhakov
- Katelan Jackson
All providers in Sandwich, MA · Optometrist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2012. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.