Peter Ebbert Hall, D.V.M ., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ME OPT860 Issued in ME

Practice address

1040 Brighton Ave
Cornerbrook Plaza Eyecare/Portland Eyecare
Portland, ME 04102-1030

Phone

(207) 253-5333

Fax

(207) 253-5332

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cornerbrook Plaza Eye Care P a

  dba Portland Eyecare

  • Optometrist
  • Portland, ME
  • NPI 1639469000
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1972562734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 JUSTAMERE RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051912",
            "telephone_number": "207-420-0431",
            "fax_number": "207-253-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 BRIGHTON AVE",
            "address_2": "CORNERBROOK PLAZA EYECARE/PORTLAND EYECARE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021030",
            "telephone_number": "207-253-5333",
            "fax_number": "207-253-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "PETER",
        "middle_name": "EBBERT",
        "name_prefix": "Dr.",
        "credential": "D.V.M ., O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "ME OPT860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Hall, LICSW
• Karen Elisabeth Hall, D.M.D.
• Kristianna Hall, LCSW
• Meagan Lee Hall, LMSW
• Morriana Hall
• Sarah Willow Hall, RN
• Teyonda Hall
• Brian L Halla, PA-C
• Lee D Hallagan, MD
• Sarah A. M. Hallen, M.D.

• Optometrist in Portland, ME
• Providers in Portland, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.

Verify at the official NPI Registry.