Individual provider Active NPI

Benjamin Young, OD

  • Optometrist
  • Roslindale, MA
National Provider Identifier
1003336645
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5282 Issued in MA
Practice address
4199 Washington St # 2
Roslindale, MA 02131-1733
Phone
(617) 323-7300
NPI assigned
Jun 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5282 MA Primary

Addresses

Primary practice location

4199 Washington St # 2
Roslindale, MA 02131-1733

Mailing address

4199 Washington St # 2
Roslindale, MA 02131-1733
Phone (617) 323-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20190121000166 MA Practitioner - Optometry 3375880982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Eye Institute IncGroup PAC ID 1850294125, 23 clinicians

Practice addresses (Care Compare)

4199 Washington St
Roslindale, MA 02131-1733
Phone (617) 323-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5282MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New England Eye Institute Inc. Optometrist CurrentSince Nov 26, 2018 Accepting new patients

Locations

930 Commonwealth Ave
Boston, MA 02215
Phone (617) 262-2020

4199 Washington St
#2
Roslindale, MA 02131
Phone (617) 323-7300

4199 Washington St
Roslindale, MA 02131
Phone (617) 323-4440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1003336645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 WASHINGTON ST # 2",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311733",
            "telephone_number": "617-323-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 WASHINGTON ST # 2",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311733",
            "telephone_number": "617-323-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-25",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.