Individual provider Active NPI

Mai Chu, O.D.

  • Optometrist
  • Southborough, MA
National Provider Identifier
1063643963
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OTP4768 Issued in MA
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(084) 603-1505
Fax
(508) 460-3061
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011521 IL
Optometrist 152W00000X OTP4768 MA Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

24 Newton St
Southborough, MA 01772-1215
Phone (084) 603-1505

Other names 1

  • Mai Chu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101007001280 MA Practitioner - Optometry 1254523392 Reassigns benefits to 2 organizations
I20211001002620 IL Practitioner - Optometry 1254523392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

24 Newton St
Southborough, MA 01772-1215
Phone (508) 486-4472

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011521ILMDOptometrist
OTP4768MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Sep 17, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 17, 2021 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Reliant Medical Group, Inc CurrentSince Aug 26, 2024 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2050 Pfingsten Rd
Ste 280
Glenview, IL 60026
Phone (224) 251-2020

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

33 Broad St
Boston, MA 02109
Phone (617) 742-7200

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

1 Washington St
Ste 101
Wellesley Hills, MA 02481
Phone (617) 332-1471

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1063643963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "084-603-1505",
            "fax_number": "508-460-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "084-603-1505",
            "fax_number": "508-460-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "MAI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011521",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OTP4768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAI",
            "last_name": "CHU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.