Individual provider Active NPI

Mary Bui Vo, O.D

  • Optometrist
  • Quincy, MA
National Provider Identifier
1083095806
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5318 Issued in MA
Practice address
1219 Hancock St
Quincy, MA 02169-4342
Phone
(617) 481-1857
Fax
(617) 481-5278
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2944 CT
Optometrist 152W00000X 5318 MA Primary

Addresses

Primary practice location

1219 Hancock St
Quincy, MA 02169-4342

Mailing address

1219 Hancock St
Quincy, MA 02169-4342

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
I20190619001549 MA Practitioner - Optometry 5294049029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifetime Vision LLCGroup PAC ID 6608100052, 2 clinicians

Practice addresses (Care Compare)

1219 Hancock St
Quincy, MA 02169-4342
Phone (617) 481-1857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2944CTMDProfessional Counselor
5318MAMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Vision, LLC Optometrist CurrentSince May 10, 2019 Accepting new patients

Locations

1219 Hancock St
Quincy, MA 02169
Phone (617) 481-1857

Organizations & group practices 1

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1083095806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694342",
            "telephone_number": "617-481-1857",
            "fax_number": "617-481-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "MARY",
        "middle_name": "BUI",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2944",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.