Organization Active NPI

Boston Laser Eye Institute, PC

Doing business as Boston Vision

  • Specialist
  • Brookline, MA
National Provider Identifier
1053496497
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA6694 Issued in MA
Legal business name
BOSTON LASER EYE INSTITUTE, PC
Doing business as
Boston Vision
Practice address
24 Webster PL
Brookline, MA 02445-7937
Phone
(617) 202-2020
Fax
(617) 734-3264
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Eileen Peck
Title
Credentialing Specialist
Phone
(617) 202-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA6694 MA Primary

Addresses

Primary practice location

24 Webster PL
Brookline, MA 02445-7937

Mailing address

24 Webster PL
Brookline, MA 02445-7937
Phone (617) 202-2020

Other identifiers 2

IdentifierTypeStateIssuer
1093793564OtherMANPI
1407838295OtherMANPI

Other names 1

  • Boston Vision Doing business as

Electronic endpoints 11

TypeEndpointUseAffiliation
Direct Messaging Address vyao@bostonvision.intellechartdirect.net
Direct Messaging Address npatel@bostonvision.intellechartdirect.net
Direct Messaging Address enangle@bostonvision.intellechartdirect.net
Direct Messaging Address smelki@bostonvision.intellechartdirect.net
Direct Messaging Address amartin@bostonvision.intellechartdirect.net
Direct Messaging Address jlee@bostonvision.intellechartdirect.net
Direct Messaging Address vkeshav@bostonvision.intellechartdirect.net
Direct Messaging Address mfinkelstein@bostonvision.intellechartdirect.net
Direct Messaging Address mnajafi@bostonvision.intellechartdirect.net
Direct Messaging Address jbrenner@bostonvision.intellechartdirect.net
Direct Messaging Address rkellan@bostonvision.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001090 MA Part B Supplier - Clinic/Group Practice 9739123381 Receives reassigned benefits from 27 practitioners
Practice locations: Lawrence, MA; Wellesley, MA; Milford, MA; Medford, MA; Burlington, MA; Brookline, MA; Andover, MA

National Provider Directory

National Provider Directory

Locations

159 River Rd
Ste 4
Andover, MA 01810

243 Charles St
Fl 11
Boston, MA 02114
Phone (617) 573-4306

1101 Beacon St
#6W
Brookline, MA 02446
Phone (617) 566-0062

1101 Beacon St
Ste 6W
Brookline, MA 02446
Phone (617) 566-0062

172 Cambridge St
Ste 103
Burlington, MA 01803

65 Walnut St
Ste 330
Wellesley Hls, MA 02481
Phone (617) 630-0380

3 Baldwin Green Cmn
Woburn, MA 01801
Phone (781) 376-1771

3 Baldwin Green Cmn
Ste 103
Woburn, MA 01801

Interoperability endpoints

  • Direct secure messaging: surman@bostonvision.intellechartdirect.net
  • Direct secure messaging: pgendelman@bostonvision.intellechartdirect.net
  • Direct secure messaging: lpham@bostonvision.intellechartdirect.net
  • Direct secure messaging: rsteinberg@bostonvision.intellechartdirect.net
  • Direct secure messaging: carrigg@bostonvision.intellechartdirect.net
  • Direct secure messaging: dgendelman@bostonvision.intellechartdirect.net
  • Direct secure messaging: igalvas@bostonvision.intellechartdirect.net
  • Direct secure messaging: enangle@bostonvision.intellechartdirect.net
  • Direct secure messaging: asmail@bostonvision.intellechartdirect.net
  • Direct secure messaging: dzuckerman@bostonvision.intellechartdirect.net
  • Direct secure messaging: sdunker@bostonvision.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1053496497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON LASER EYE INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "617-202-2020"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "MA6694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093793564",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407838295",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vyao@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enangle@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smelki@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amartin@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlee@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vkeshav@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfinkelstein@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnajafi@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrenner@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkellan@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Boston Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.