Individual provider Active NPI

Peter John Violette, OD

  • Optometrist
  • Wakefield, MA
National Provider Identifier
1003945296
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3326 Issued in MA
Practice address
333 North Ave
Wakefield, MA 01880-2300
Phone
(781) 245-3135
Fax
(781) 245-4518
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3326 MA Primary

Addresses

Primary practice location

333 North Ave
Wakefield, MA 01880-2300

Mailing address

333 North Ave
Suite 1
Wakefield, MA 01880-2300
Phone (781) 245-3135

Other identifiers 3

IdentifierTypeStateIssuer
W15753OtherMABLUE CROSS AND BLUE SHIEL
15158-5OtherMAHARVARD PILGRIM
716213OtherMATUFTS

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
I20071221000533 MA Practitioner - Optometry 2860582251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

333 N Ave
Wakefield, MA 01880-2300
Phone (781) 245-3135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3326MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peter J. Violette O.D.,P.C. Optometrist CurrentSince Jul 1, 1990 Accepting new patients

Locations

333 North Ave
Wakefield, MA 01880
Phone (781) 245-3135

333 North Ave
Fl 1
Wakefield, MA 01880

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1003945296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NORTH AVE",
            "address_2": "SUITE 1",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802300",
            "telephone_number": "781-245-3135",
            "fax_number": "781-245-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NORTH AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802300",
            "telephone_number": "781-245-3135",
            "fax_number": "781-245-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIOLETTE",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "W15753",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "15158-5",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "716213",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

Verify at the official NPI Registry.