NPIMap

Organization Active NPI

Boston University Eye Associates, Inc.

  • Ophthalmology Physician
  • Taunton, MA
National Provider Identifier
1154317865
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
N/A Issued in MA
Legal business name
BOSTON UNIVERSITY EYE ASSOCIATES, INC.
Practice address
2005 Bay St Ste 206
Taunton, MA 02780-1085
Phone
(508) 823-7473
Fax
(508) 824-3830
NPI assigned
Sep 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Dr. Stephen P. ChristiansenNPI 1134156680
Title
Chairman
Phone
(617) 414-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X N/A MA
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X N/A MA Primary
Ambulatory Surgical Clinic/Center 261QA1903X N/A MA

Addresses

Primary practice location

2005 Bay St Ste 206
Taunton, MA 02780-1085

Mailing address

2005 Bay St Ste 206
Taunton, MA 02780-1085
Phone (508) 823-7473

Other identifiers 7

IdentifierTypeStateIssuer
9766162MedicaidMA
600685OtherMATUFTS (FACILITY)
M88004OtherMABCBS (FACILITY)
M15401OtherMABCBS (MD'S)
615277OtherMATUFTS (PRACTICE)
93923OtherMAAETNA
W20231OtherMABCBS (OPTOMETRY)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000948 MA Part B Supplier - Clinic/Group Practice 4789571225 Receives reassigned benefits from 29 practitioners
Practice locations: Brockton, MA; Middleboro, MA; Taunton, MA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Boston University Eye Associates Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1154317865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 BAY ST STE 206",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027801085",
            "telephone_number": "508-823-7473",
            "fax_number": "508-824-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 BAY ST STE 206",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027801085",
            "telephone_number": "508-823-7473",
            "fax_number": "508-824-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON UNIVERSITY EYE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "617-414-2020",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "N/A",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MA",
            "license": "N/A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9766162",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS (FACILITY)",
            "identifier": "600685",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (FACILITY)",
            "identifier": "M88004",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (MD'S)",
            "identifier": "M15401",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS (PRACTICE)",
            "identifier": "615277",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "93923",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (OPTOMETRY)",
            "identifier": "W20231",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taunton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.