Individual provider Active NPI

Richard M Lubas, O.D.

  • Optometrist
  • Brockton, MA
National Provider Identifier
1164588497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4196 Issued in MA
Practice address
700 Oak St
Brockton, MA 02301-1105
Phone
(508) 584-8886
Fax
(508) 584-8500
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4196 MA Primary

Addresses

Primary practice location

700 Oak St
Brockton, MA 02301-1105

Mailing address

30 Old Farm Rd
Bridgewater, MA 02324-3448
Phone (508) 584-8886

Other identifiers 1

IdentifierTypeStateIssuer
0320625MedicaidMA

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
I20101229000925 MA Practitioner - Optometry 0244428647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

36 Paramount Dr
Raynham, MA 02767-1001
Phone (508) 822-8626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4196MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Volare Eyecare PC Optometrist CurrentSince Jan 31, 2016 Accepting new patients

Locations

36 Paramount Dr
Raynham, MA 02767
Phone (508) 822-7122

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164588497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OLD FARM RD",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023243448",
            "telephone_number": "508-584-8886",
            "fax_number": "508-584-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OAK ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011105",
            "telephone_number": "508-584-8886",
            "fax_number": "508-584-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBAS",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320625",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.