NPIMap

Organization Active NPI

Family Eye Care, Inc.

  • Optometrist
  • Worcester, MA
National Provider Identifier
1073674446
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3463 Issued in MA
Legal business name
FAMILY EYE CARE, INC.
Practice address
335 Park Ave
Worcester, MA 01610-1000
Phone
(508) 753-5103
Fax
(508) 753-6395
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Dr. Brian Steven Thamel, O.D.NPI 1508927054
Title
President
Phone
(508) 753-5103

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 3463 MA Primary

Addresses

Primary practice location

335 Park Ave
Worcester, MA 01610-1000

Mailing address

335 Park Ave
Worcester, MA 01610-1000
Phone (508) 753-5103

Other identifiers 1

IdentifierTypeStateIssuer
9715070MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080617000732 MA Part B Supplier - Clinic/Group Practice 3779654876 Receives reassigned benefits from 6 practitioners
Practice locations: Spencer, MA; Worcester, MA

National Provider Directory

National Provider Directory

Locations

335 Park Ave
Ste 5
Worcester, MA 01610

Practitioners & affiliated clinicians

Practitioners 8

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1073674446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016101000",
            "telephone_number": "508-753-5103",
            "fax_number": "508-753-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016101000",
            "telephone_number": "508-753-5103",
            "fax_number": "508-753-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "THAMEL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-753-5103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9715070",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.