Individual provider Active NPI

Mina Sehizadeh, O.D., MSC

  • Optometrist
  • Boston, MA
National Provider Identifier
1124332994
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4754 Issued in MA
Practice address
133 Brookline Ave
Boston, MA 02215-3904
Phone
(617) 421-1151
Fax
(617) 421-8787
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4754 MA Primary

Addresses

Primary practice location

133 Brookline Ave
Boston, MA 02215-3904

Mailing address

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1151

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msehizadehod41874@direct.atrius.masshiway.net

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
I20110309000996 MA Practitioner - Optometry 8527240753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4754MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Optometrist Current Accepting new patients
Atrius Health, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

77 Herrick St
Ste 101
Beverly, MA 01915
Phone (978) 232-7115

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

Interoperability endpoints

  • Direct secure messaging: msehizadehod41874@direct.atrius.masshiway.net

Organizations & group practices 3

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1124332994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-1151",
            "fax_number": "617-421-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-1151",
            "fax_number": "617-421-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEHIZADEH",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "O.D., MSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msehizadehod41874@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "133 Brookline Ave",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "022153904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.