Individual provider Active NPI

Lynn Brandes, OD

  • Optometrist
  • Brockton, MA
National Provider Identifier
1053489294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3580 Issued in MA
Practice address
21 Torrey St
Brockton, MA 02301-4849
Phone
(508) 587-8344
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3580 MA Primary

Addresses

Primary practice location

21 Torrey St
Brockton, MA 02301-4849

Mailing address

11 Kennedy Road
Sharon, MA 02067

Other identifiers 3

IdentifierTypeStateIssuer
0335380MedicaidMA
W16283OtherMABCBS
0027835OtherMANHP

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
I20050131001031 MA Practitioner - Optometry 3870543416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare-Eyewear Assoc., P.C.Group PAC ID 1951491380, 3 clinicians

Practice addresses (Care Compare)

45 Cohannet St
Taunton, MA 02780-3903
Phone (508) 824-4100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare-Eyewear Assoc., P.C. Optometrist CurrentSince Jan 5, 2019 Accepting new patients
Tchao Eye Associates LLC Optometrist PastSince Feb 4, 2024 Accepting new patients

Locations

45 Cohannet St
Taunton, MA 02780
Phone (508) 823-0781

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053489294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KENNEDY ROAD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "02067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014849",
            "telephone_number": "508-587-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDES",
        "first_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0335380",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W16283",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0027835",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.