Active NPI
Thomas R Fabello, OD
- Optometrist
- Lowell, MA
National Provider Identifier
1013900745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2809
- Practice address
- 159 Central St
Lowell, MA 01852-1923 - Phone
- (978) 459-6262
- Fax
- (978) 458-0358
- NPI assigned
- Aug 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2809 | MA | Primary |
Addresses
Primary practice location
159 Central St
Lowell, MA 01852-1923
Mailing address
159 Central St
Lowell, MA 01852-1923
Phone (978) 459-6262
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0344206 | Medicaid | MA | |
| 979552 | Other | MA | NETWORK HEALTH |
| 151299 | Other | MA | HARVARD PILGRIM |
| W15680 | Other | MA | BLUE CROSS BLUE SHIELD |
| 115581 | Other | MA | EYEMED |
| 0004866 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 0339008 | Medicaid | MA | |
| 469330 | Other | MA | TUFTS TOTAL HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2809 | MA | MD | Mechanotherapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dental of Lowell Inc | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Lowell, MA
- NPI 1497820443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013900745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 CENTRAL ST",
"city": "LOWELL",
"state": "MA",
"postal_code": "018521923",
"telephone_number": "978-459-6262",
"fax_number": "978-458-0358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 CENTRAL ST",
"city": "LOWELL",
"state": "MA",
"postal_code": "018521923",
"telephone_number": "978-459-6262",
"fax_number": "978-458-0358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABELLO",
"first_name": "THOMAS",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "2809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0344206",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "979552",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "151299",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W15680",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "115581",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0004866",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0339008",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS TOTAL HEALTH PLAN",
"identifier": "469330",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.