NPIMap

Organization Active NPI

Mass Optometric Associates, P. C.

  • Optometrist
  • Watertown, MA
National Provider Identifier
1083804249
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MASS OPTOMETRIC ASSOCIATES, P. C.
Practice address
3 Mount Auburn St
Watertown Square Plaza, Suite 2
Watertown, MA 02472-3923
Phone
(617) 926-8443
Fax
(617) 926-8458
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Dolsie McDonald
Title
Credentialing Manager
Phone
(726) 444-4078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X MA Primary

Addresses

Primary practice location

3 Mount Auburn St
Watertown Square Plaza, Suite 2
Watertown, MA 02472-3923

Mailing address

175 E Houston St
San Antonio, TX 78205-2299
Phone (800) 340-0129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070824000362 MA Part B Supplier - Clinic/Group Practice 0648362442 Receives reassigned benefits from 94 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westwood, MA; Billerica, MA; Wareham, MA; Shrewsbury, MA; Seekonk, MA; Saugus, MA; Quincy, MA; Plymouth, MA…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mass Optometric Associates PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1083804249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052299",
            "telephone_number": "800-340-0129",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MOUNT AUBURN ST",
            "address_2": "WATERTOWN SQUARE PLAZA, SUITE 2",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024723923",
            "telephone_number": "617-926-8443",
            "fax_number": "617-926-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASS OPTOMETRIC ASSOCIATES, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DOLSIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "726-444-4078"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.