Active NPI
Jennifer M Liao, OD
- Optometrist
- Boston, MA
National Provider Identifier
1144644147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4987
- Practice address
- 930 Commonwealth Ave
Suite 2a
Boston, MA 02215-1274 - Phone
- (617) 262-2020
- NPI assigned
- Feb 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4987 | MA | Primary |
Addresses
Primary practice location
930 Commonwealth Ave
Suite 2a
Boston, MA 02215-1274
Mailing address
63 Brentwood St
Allston, MA 02134-1302
Phone (617) 388-3751
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190515001484 | MA | Practitioner - Optometry | 4587907522 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New England Eye Institute Inc
Practice addresses (Care Compare)
930 Commonwealth Ave
Boston, MA 02215-1220
Phone (617) 262-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4987 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New England Eye Institute Inc. | Optometrist | Current | Accepting new patients |
Locations
930 Commonwealth Ave
Ste 2A
Boston, MA 02215
Phone (617) 262-2020
930 Commonwealth Ave
Boston, MA 02215
Phone (617) 262-2020
Organizations & group practices 1
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": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1144644147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 BRENTWOOD ST",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021341302",
"telephone_number": "617-388-3751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 COMMONWEALTH AVE",
"address_2": "SUITE 2A",
"city": "BOSTON",
"state": "MA",
"postal_code": "022151274",
"telephone_number": "617-262-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIAO",
"first_name": "JENNIFER",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-11",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.