Individual provider Active NPI

Ceida P Chan, O.D.

  • Optometrist
  • Boston, MA
National Provider Identifier
1023028057
Registry record updated Sep 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4399 Issued in MA
Practice address
780 Albany St
Boston, MA 02118-2755
Phone
(857) 654-1000
Fax
(857) 654-1100
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4399 MA Primary

Addresses

Primary practice location

780 Albany St
Boston, MA 02118-2755

Mailing address

930 Commonwealth Ave
Suite 2a New England Eye Institute
Boston, MA 02215
Phone (617) 262-2020

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
I20060926000169 MA Practitioner - Optometry 4183629165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Health Care for the Homeless Program, Inc. 75 clinicians

Practice addresses (Care Compare)

363 Albany St
Boston, MA 02118-2503
Phone (857) 654-1865

444 Harrison Ave
Boston, MA 02118-2404
Phone (857) 654-1850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Boston Health Care for the Homeless Program, Inc. CurrentSince Aug 14, 2023 Accepting new patients

Locations

780 Albany St
Boston, MA 02118
Phone (857) 654-1000

780 Albany St
#2130
Boston, MA 02118

Interoperability endpoints

  • Direct secure messaging: cchan189428@direct.ochin.org

Organizations & group practices 11

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1023028057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 COMMONWEALTH AVE",
            "address_2": "SUITE 2A NEW ENGLAND EYE INSTITUTE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-262-2020",
            "fax_number": "617-587-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "857-654-1000",
            "fax_number": "857-654-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CEIDA",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.