Jake Duclos Fiore, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5569 Issued in MA

Practice address

289 Moody St
Waltham, MA 02453-5284

Phone

(781) 894-2127

NPI assigned

Jun 13, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Ejc Eyecare LLCGroup PAC ID 6901952134, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ejc Eyecare, LLC

  • Optometrist
  • Waltham, MA
  • NPI 1235368275
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1104556232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 MOODY ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535284",
            "telephone_number": "781-894-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 MOODY ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535284",
            "telephone_number": "781-894-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORE",
        "first_name": "JAKE",
        "middle_name": "DUCLOS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-11-01",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5569",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Figueroa
• Nancy E. Fillio, LICSW
• Find Your Smile, P.C.
• Finer Counseling LLC
• Shannon Finney, LMHC
• First Response Clinical Services, LLC
• Molly Rebecca Fischman, M.S., CF-SLP
• Lucy Fisher, MSW
• Taylor Fitch, PHARMD
• James Michael Fitzgerald, LMHC

• Optometrist in Waltham, MA
• Providers in Waltham, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.