Organization Active NPI

Personal Eyes Inc

  • Optometrist
  • Randolph, MA
National Provider Identifier
1043385412
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PERSONAL EYES INC
Practice address
1157 N Main St
Randolph, MA 02368-2135
Phone
(781) 963-2333
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Authorized official

Name
Marvin J Hertzel, OD
Title
Partner
Phone
(781) 963-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1157 N Main St
Randolph, MA 02368-2135

Mailing address

1157 N Main St
Randolph, MA 02368-2135

Other identifiers 3

IdentifierTypeStateIssuer
885521OtherTUFTS
W20255OtherBCBS
9720821MedicaidMA

Other names 1

  • MARVIN HERTZEL PRES Other name

National Provider Directory

National Provider Directory

Locations

1157 N Main St
Randolph, MA 02368
Phone (781) 963-2333

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1043385412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682135",
            "telephone_number": "781-963-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL EYES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "HERTZEL",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "781-963-2333",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "885521",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W20255",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9720821",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARVIN HERTZEL PRES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.