Individual provider Active NPI

Judith Ann Driscoll, O.D.

  • Optometrist
  • Greenfield, MA
National Provider Identifier
1073593059
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4285 Issued in MA
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

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120705000485 TX Practitioner - Optometry 9931127537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000921VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word CurrentSince Sep 1, 2021 Accepting new patients
University of the Incarnate Word Optometrist CurrentSince Sep 1, 2021 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.