Active NPI
Judith Ann Driscoll, O.D.
- Optometrist
- Greenfield, MA
National Provider Identifier
1073593059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4285
- Practice address
- Main Street Optical, 219 Main Street
Greenfield, MA 01301 - Phone
- (413) 772-0999
- Fax
- (413) 772-5999
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000921 | VA | |
| Optometrist | 152W00000X | 4285 | MA | Primary |
Addresses
Primary practice location
Main Street Optical, 219 Main Street
Greenfield, MA 01301
Mailing address
5832 Oakland Park Dr
Burke, VA 22015-2440
Phone (703) 250-7320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618000921 | VA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of the Incarnate Word | Current | Accepting new patients | |
| University of the Incarnate Word | Optometrist | Current | Accepting new patients |
| Mathews & Mathews Opt Inc | Optometrist | Past | Accepting new patients |
Locations
9725 Datapoint Dr
San Antonio, TX 78229
Phone (210) 283-6800
2547 E Commerce St
San Antonio, TX 78203
Phone (210) 283-6331
9725 Datapoint Dr
#69
San Antonio, TX 78229
Phone (210) 283-6800
Interoperability endpoints
- judith.driscoll@uprisedirect.com
Organizations & group practices 3
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.
-
- Optometrist
- San Antonio, TX
- NPI 1003129784
-
- Family Nurse Practitioner
- San Antonio, TX
- NPI 1033591706
-
- Optometrist
- Fort Sam Houston, TX
- NPI 1326240763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1073593059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5832 OAKLAND PARK DR",
"city": "BURKE",
"state": "VA",
"postal_code": "220152440",
"telephone_number": "703-250-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MAIN STREET OPTICAL, 219 MAIN STREET",
"city": "GREENFIELD",
"state": "MA",
"postal_code": "01301",
"telephone_number": "413-772-0999",
"fax_number": "413-772-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRISCOLL",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-18",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618000921",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.