Organization Active NPI

Eye Associates of Needham PC

  • Ophthalmology Physician
  • Needham, MA
National Provider Identifier
1164560173
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE ASSOCIATES OF NEEDHAM PC
Practice address
400 Hillside Ave
Needham, MA 02494-1263
Phone
(781) 444-6610
Fax
(781) 455-6597
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Dr. Evan Gold, M.D.NPI 1760441034
Title
Owner
Phone
(781) 444-6610

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

400 Hillside Ave
Needham, MA 02494-1263

Mailing address

400 Hillside Ave
Needham, MA 02494-1263
Phone (781) 444-6610

Other identifiers 1

IdentifierTypeStateIssuer
9777334MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607000542 MA Part B Supplier - Clinic/Group Practice 1456333020 Receives reassigned benefits from 2 practitioners
Practice locations: Needham, MA

National Provider Directory

National Provider Directory

Locations

400 Hillside Ave
Ste 3
Needham Heights, MA 02494
Phone (617) 444-6610

Practitioners & affiliated clinicians

Practitioners 2

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1164560173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HILLSIDE AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941263",
            "telephone_number": "781-444-6610",
            "fax_number": "781-455-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HILLSIDE AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941263",
            "telephone_number": "781-444-6610",
            "fax_number": "781-455-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF NEEDHAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-444-6610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9777334",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.