Organization Active NPI

North Shore Cataract and Laser Center, LLC

  • Ophthalmologic Surgery Clinic/Center
  • Stoneham, MA
National Provider Identifier
1144287350
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
Legal business name
NORTH SHORE CATARACT AND LASER CENTER, LLC
Practice address
91 Montvale Ave
Stoneham, MA 02180
Phone
(781) 438-5995
Fax
(781) 279-1238
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Mr. Kenneth J Camerota
Title
Administrator
Phone
(781) 331-3820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X Primary

Addresses

Primary practice location

91 Montvale Ave
Stoneham, MA 02180

Mailing address

91 Montvale Ave
Stoneham, MA 02180
Phone (781) 438-5995

Other identifiers 5

IdentifierTypeStateIssuer
M88024OtherBCBS
1857975MedicaidMA
221037OtherMAMEDICARE PART B
694202OtherTUFTS
903499OtherHPHC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100105000025 MA Part B Supplier - Ambulatory Surgical Center 0840331427 Practice locations: Stoneham, MA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North Shore Cataract and Laser Center LLCCCN 22C0001037
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0998237North Shore Cataract and Laser Ctr LLC91 Montvale Avenue, 3Rd Floor, Stoneham, MA 02180Certificate of waiverApr 9, 2028

National Provider Directory

National Provider Directory

Locations

91 Montvale Ave
Fl 3
Stoneham, MA 02180
Phone (781) 438-5995

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1144287350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-438-5995",
            "fax_number": "781-279-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-438-5995",
            "fax_number": "781-279-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE CATARACT AND LASER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "CAMEROTA",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "781-331-3820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M88024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1857975",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "221037",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "694202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "903499",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.