Individual provider Active NPI

Yu-Qiong Niu, OD

  • Optometrist
  • Brookline, MA
National Provider Identifier
1063086874
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5458 Issued in MA
Practice address
1623 Beacon St
Brookline, MA 02445
Phone
(415) 244-9903
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5458 MA Primary

Addresses

Primary practice location

1623 Beacon St
Brookline, MA 02445

Mailing address

7 Perkins Square Apt 11
Jamaica Plain, MA 02130
Phone (415) 244-9903

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
I20210623002633 MA Practitioner - Optometry 2860893229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5458MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, PLLC Optometrist CurrentSince May 27, 2021 Accepting new patients
Mass Optometric Associates, PLLC Optometrist CurrentSince May 27, 2021 Accepting new patients

Locations

700 Boston Rd
Billerica, MA 01821
Phone (978) 667-0481

1623 Beacon St
Brookline, MA 02445
Phone (617) 739-2707

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1063086874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PERKINS SQUARE APT 11",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "415-244-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "415-244-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIU",
        "first_name": "YU-QIONG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.