Philip Lloyd Crooks, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

MA 4265 Issued in MA

Practice address

339 Squire Rd
Pearle Vision
Revere, MA 02151-4309

Phone

(781) 289-5900

Fax

(781) 289-6135

NPI assigned

Jan 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1043495260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 SQUIRE RD",
            "address_2": "PEARLE VISION",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021514309",
            "telephone_number": "781-289-5900",
            "fax_number": "781-289-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 SQUIRE RD",
            "address_2": "PEARLE VISION",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021514309",
            "telephone_number": "781-289-5900",
            "fax_number": "781-289-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "PHILIP",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA 4265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janis M Cotter, O.D.
• Philip J Cotter
• Marie Antoinette Paraiso Coughlin, RN
• Lakshmi Kolagotla Cox, MD
• Bridget Craig
• Kevin Arthur Cummings, PHYSICAL THERAPIST
• Lynn Cunningham, RN
• CVS Pharmacy Inc
• CVS Pharmacy Inc.
• Joseph Michael Czupryna, DPT

• Optometrist in Revere, MA
• Providers in Revere, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.