Individual provider Active NPI

Alexandra M O'Donnell, OD

  • Optometrist
  • Providence, RI
National Provider Identifier
1184355836
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTG-00737 Issued in RI
Practice address
891 Westminster St
Providence, RI 02903-4020
Phone
(401) 331-7850
Fax
(401) 274-4739
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X ODTG-00737 RI Primary

Addresses

Primary practice location

891 Westminster St
Providence, RI 02903-4020

Mailing address

1123 Avalon Dr
Sharon, MA 02067-1092
Phone (401) 651-7109

Other practice location 1

940 Belmont St
Brockton, MA 02301-5596
Phone (508) 583-4500

Other names 1

  • Alexandra M Goralski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20230426000407 RI Practitioner - Optometry 1052776010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westminster Eyecare Associates IncGroup PAC ID 6305804907, 11 clinicians

Practice addresses (Care Compare)

891 Westminster St
Providence, RI 02903-4020
Phone (401) 688-2301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Westminster Eyecare Associates Inc Optometrist CurrentSince Apr 17, 2023 Accepting new patients
Smithfield Eye & Optical LLC Optometrist Past Accepting new patients

Locations

891 Westminster St
Providence, RI 02903
Phone (401) 331-7850

Organizations & group practices 2

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1184355836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 AVALON DR",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671092",
            "telephone_number": "401-651-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 WESTMINSTER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034020",
            "telephone_number": "401-331-7850",
            "fax_number": "401-274-4739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023015596",
            "country_code": "US",
            "telephone_number": "508-583-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "ALEXANDRA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG-00737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "GORALSKI",
            "middle_name": "M",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.