Individual provider Active NPI

Zhenzhen Gao, OD

  • Optometrist
  • Revere, MA
National Provider Identifier
1194379115
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5440 Issued in MA
Practice address
339 Squire Rd Unit 200
Revere, MA 02151-4309
Phone
(781) 289-5900
NPI assigned
Jul 29, 2019
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5440 MA Primary

Addresses

Primary practice location

339 Squire Rd Unit 200
Revere, MA 02151-4309

Mailing address

212 Merrimack Meadows LN
Tewksbury, MA 01876-1083
Phone (203) 285-5639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210126000822 MA Practitioner - Optometry 7810301280 Reassigns benefits to 2 organizations
I20230314001885 NH Practitioner - Optometry 7810301280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5440MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Apr 13, 2021 Accepting new patients
Optometric Providers of New Hampshire, PLLC Optometrist CurrentSince Dec 8, 2022 Accepting new patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Apr 13, 2021 Accepting new patients
Optometric Providers of New Hampshire, PLLC Optometrist CurrentSince Dec 8, 2022 Accepting new patients

Locations

700 Boston Rd
Billerica, MA 01821
Phone (978) 667-0481

70 Worcester Providence Tpke
Ste 507
Millbury, MA 01527
Phone (508) 865-5196

346 S Broadway
#28
Salem, NH 03079
Phone (603) 898-8560

Organizations & group practices 6

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1194379115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 MERRIMACK MEADOWS LN",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761083",
            "telephone_number": "203-285-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 SQUIRE RD UNIT 200",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021514309",
            "telephone_number": "781-289-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAO",
        "first_name": "ZHENZHEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

Verify at the official NPI Registry.