Organization Active NPI

Sandra M. Payton Vision Care, Inc

  • Optometrist
  • Quincy, MA
National Provider Identifier
1053684027
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4696 Issued in MA
Legal business name
SANDRA M. PAYTON VISION CARE, INC
Practice address
1147 Hancock St Ste E
Quincy, MA 02169-4330
Phone
(857) 300-3039
NPI assigned
Feb 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Sandra PaytonNPI 1851549224
Title
Optometrist
Phone
(857) 300-3039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4696 MA Primary

Addresses

Primary practice location

1147 Hancock St Ste E
Quincy, MA 02169-4330

Mailing address

PO Box 749
Randolph, MA 02368-0749

Other identifiers 1

IdentifierTypeStateIssuer
0719617MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120712000185 MA Part B Supplier - Clinic/Group Practice 2961667241 Receives reassigned benefits from 1 practitioner
Practice locations: Quincy, MA

National Provider Directory

National Provider Directory

Locations

1147 Hancock St
Ste E
Quincy, MA 02169
Phone (857) 300-3039

Practitioners & affiliated clinicians

Practitioners 1

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": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1053684027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023680749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 HANCOCK ST STE E",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694330",
            "telephone_number": "857-300-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA M. PAYTON VISION CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "PAYTON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "857-300-3039",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0719617",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.