Individual provider Active NPI

Jenna A Loughlin, O.D.

  • Optometrist
  • Boston, MA
National Provider Identifier
1174806947
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4895 Issued in MA
Practice address
50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone
(617) 367-4800
Fax
(617) 723-7028
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4895 MA Primary

Addresses

Primary practice location

50 Staniford St
Suite 600
Boston, MA 02114-2517

Mailing address

50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone (617) 367-4800

Other identifiers 1

IdentifierTypeStateIssuer
110102412AMedicaidMA

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
I20121017000544 MA Practitioner - Optometry 1456501006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4895MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Atrius Health, Inc. Optometrist Current Accepting new patients
Atrius Health, Inc. CurrentSince Nov 1, 2021 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

Interoperability endpoints

  • Direct secure messaging: jloughlinod72052@direct.atrius.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1174806947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-367-4800",
            "fax_number": "617-723-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-367-4800",
            "fax_number": "617-723-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHLIN",
        "first_name": "JENNA",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102412A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.