Individual provider Active NPI

Aparna Raghuram, O.D, PH.D

  • Optometrist
  • Boston, MA
National Provider Identifier
1053560706
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4680 Issued in MA
Practice address
300 Longwood Ave
Fegan 4, Department of Ophthalmology
Boston, MA 02115-5724
Phone
(617) 355-6401
Fax
(617) 730-0392
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4680 MA Primary
Pediatric Optometrist 152WP0200X 4680 MA

Addresses

Primary practice location

300 Longwood Ave
Fegan 4, Department of Ophthalmology
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Fegan 4, Department of Ophthalmology
Boston, MA 02115-5724
Phone (617) 355-6401

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
I20131107000691 MA Practitioner - Optometry 7113152794 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Ophthalmology Foundation Inc Optometrist CurrentSince Aug 14, 2013 Accepting new patients

Locations

300 Longwood Ave
#4
Boston, MA 02115
Phone (617) 355-6401

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
Ofc
Boston, MA 02115
Phone (617) 355-8083

Interoperability endpoints

  • Direct secure messaging: araghuram30889@direct.bostonchildrens.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1053560706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 4, DEPARTMENT OF OPHTHALMOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6401",
            "fax_number": "617-730-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 4, DEPARTMENT OF OPHTHALMOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6401",
            "fax_number": "617-730-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHURAM",
        "first_name": "APARNA",
        "name_prefix": "Dr.",
        "credential": "O.D, PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4680",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "4680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.