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EYECARE MEDICAL GROUP OPTICAL SHOP
NPI 1184729915
Eyewear Supplier in Portland, ME

Active since September 14, 2006CLIA Certified · 2 labs
53 SEWALL STREET, PORTLAND, ME 04102(207) 828-2020(207) 773-7034 Get Directions Write a Review

NPPES record last updated: July 31, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eyecare Medical Group Optical Shop NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EYECARE MEDICAL GROUP OPTICAL SHOP (NPI 1184729915) is a healthcare organization registered as an eyewear supplier in Portland, Maine and active in the NPI registry since September 2006. The organization holds 2 active CLIA laboratory certificates and lists Lynn Shorty, Chief Operating Offier, as its authorized official.

NPPES Registry Identity

NPI1184729915
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameEYECARE MEDICAL GROUP OPTICAL SHOP
Location Address53 SEWALL STREETPortland, ME 04102
Mailing Address53 Sewall StreetPortland, ME 04102 · (207) 773-9597 · Fax (207) 773-7034
Phone(207) 828-2020
Fax(207) 773-7034
Organization SubpartNo
Authorized OfficialLynn ShortyChief Operating Offier · (207) 791-8234
Enumeration DateSeptember 14, 2006
Last NPPES UpdateJuly 31, 2023
NPPES CertifiedJuly 31, 2023
✔ NPI 1184729915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
53 SEWALL STREET, Portland, ME 04102
Open in Google Maps ↗

Other Identifiers 1

Medicaid109280300ME

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D0992976

Eyecare Medical Group · Portland, ME
Active · expires Oct 30, 2027
CLIA Number20D0992976
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateOctober 31, 2025
Certificate Expiration DateOctober 30, 2027
Laboratory DirectorRobert W. Daly
Laboratory Phone(888) 374-2020
Laboratory LocationEyecare Medical Group53 Sewall Street Attn Tina Bellino, Portland, ME 04102
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 20D2266878

Eyecare Medical Group-Saco Satelite · Saco, ME
Active · expires Aug 16, 2026
CLIA Number20D2266878
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorRobert W. Daly
Laboratory Phone(207) 828-2020
Laboratory LocationEyecare Medical Group-Saco Satelite655 Main Street, Saco, ME 04072
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT M STEIDL MD
Ophthalmology
53 SEWALL STREET
PORTLAND, ME 04102
Cumberland County (207) 828-2020
JACKIE K NGUYEN MD
Ophthalmology
53 SEWALL STREET
PORTLAND, ME 04102
Cumberland County (207) 828-2020
EYECARE MEDICAL GROUP
Clinic/Center (Ambulatory Surgical)
53 SEWALL STREET
PORTLAND, ME 04102
Cumberland County (207) 828-2020
JORDAN ERIC STERRER MD
Ophthalmology
53 SEWALL STREET
PORTLAND, ME 04102
Cumberland County (207) 828-2020
EYECARE MEDICAL GROUP
Ophthalmology
53 SEWALL STREET
PORTLAND, ME 04102
Cumberland County (207) 828-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eyecare Medical Group Optical Shop's NPI number?

The NPI number for Eyecare Medical Group Optical Shop is 1184729915. It was assigned to this organization in the NPPES registry on September 14, 2006.

Where is Eyecare Medical Group Optical Shop located?

Eyecare Medical Group Optical Shop is located at 53 Sewall Street, Portland, ME 04102. The listed phone number is (207) 828-2020.

What is Eyecare Medical Group Optical Shop's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Eyecare Medical Group Optical Shop hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Eyecare Medical Group Optical Shop was last updated on July 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.