Individual provider Active NPI

Lisa Marie Pilleri, OD

  • Optometrist
  • Saugus, MA
National Provider Identifier
1013074533
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3912 Issued in MA
Practice address
335 Main St
Saugus, MA 01906-3143
Phone
(781) 233-9570
Fax
(781) 233-9571
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 3912 MA Primary

Addresses

Primary practice location

335 Main St
Saugus, MA 01906-3143

Mailing address

335 Main St
Saugus, MA 01906-3143
Phone (781) 233-9570

Other identifiers 1

IdentifierTypeStateIssuer
0369381MedicaidMA

Other names 1

  • Dr. Lisa Marie Mignault Former name

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
I20070314000421 MA Practitioner - Optometry 4789787607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Vision Works IncGroup PAC ID 7517063050, 2 clinicians

Practice addresses (Care Compare)

335 Main St
Saugus, MA 01906-3143
Phone (781) 233-9570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3912MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Vision Works Inc Optometrist CurrentSince Mar 1, 2007 Accepting new patients

Locations

335 Main St
Saugus, MA 01906
Phone (781) 233-9570

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1013074533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 MAIN ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019063143",
            "telephone_number": "781-233-9570",
            "fax_number": "781-233-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 MAIN ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019063143",
            "telephone_number": "781-233-9570",
            "fax_number": "781-233-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLERI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0369381",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MIGNAULT",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saugus, MA

Sources for this page

Verify at the official NPI Registry.