Individual provider Active NPI

Maura Lee Trail-O'Brien, OD

  • Optometrist
  • Haverhill, MA
National Provider Identifier
1093741530
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4424 Issued in MA
Practice address
72 Merrimack St
Haverhill, MA 01830-6207
Phone
(978) 374-0386
Fax
(978) 372-3631
NPI assigned
Jun 25, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTA00515 RI
Optometrist 152W00000X 4424 MA Primary

Addresses

Primary practice location

72 Merrimack St
Haverhill, MA 01830-6207

Mailing address

72 Merrimack St
Haverhill, MA 01830-6207
Phone (978) 374-0386

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
I20071204000103 MA Practitioner - Optometry 7012925175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Suburban Eye Associates PCGroup PAC ID 5193747186, 10 clinicians

Practice addresses (Care Compare)

669 Main St
Wakefield, MA 01880-5221
Phone (781) 245-5200

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
74.43
Improvement activities
40
Cost
77.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4424MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
North Suburban Eye Associates LLC CurrentSince Jun 19, 2019 Accepting new patients
North Suburban Eye Associates PC Optometrist CurrentSince Dec 16, 2012 Accepting new patients
Frederic Rose, OD Optometrist Past Accepting new patients
Lein-Thu Van Dao Optometrist Past Accepting new patients

Locations

669 Main St
Wakefield, MA 01880
Phone (781) 245-5200

955 Main St
Ste 108
Winchester, MA 01890
Phone (781) 721-0447

Interoperability endpoints

  • Direct secure messaging: maura.trail.p1@direct.northsuburbaneye.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1093741530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-374-0386",
            "fax_number": "978-372-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-374-0386",
            "fax_number": "978-372-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIL-O'BRIEN",
        "first_name": "MAURA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00515",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.