Active NPI
Joseph R. Erickson, RDO
- Optician
- Worcester, MA
National Provider Identifier
1033396791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 4453
- Practice address
- 12 Palace Gardens Rd
Worcester, MA 01607-1725 - Phone
- (508) 365-8771
- NPI assigned
- Jan 24, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 4453 | MA | Primary |
Addresses
Primary practice location
12 Palace Gardens Rd
Worcester, MA 01607-1725
Mailing address
12 Palace Gardens Rd
Worcester, MA 01607-1725
Phone (508) 365-8771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0715794 | Medicaid | MA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4453 | MA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transvision, Inc. | Optician | 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.
-
- Optician
- Worcester, MA
- NPI 1538347489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201132800000",
"number": "1033396791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 PALACE GARDENS RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071725",
"telephone_number": "508-365-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 PALACE GARDENS RD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071725",
"telephone_number": "508-365-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "JOSEPH",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "RDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-24",
"last_updated": "2008-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MA",
"license": "4453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0715794",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.