Active NPI
Premium Eye Care, PC
Doing business as Westwood Eyecare and Optical
- Optometrist
- Westwood, MA
National Provider Identifier
1205871928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3168
- Legal business name
- PREMIUM EYE CARE, PC
- Doing business as
- Westwood Eyecare and Optical
- Practice address
- 738 High St
Westwood, MA 02090-2503 - Phone
- (781) 329-5454
- Fax
- (781) 329-7813
- NPI assigned
- Jun 17, 2006
- Last updated
- Jun 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cory Lavallee, OD
- Title
- OD, Owner
- Phone
- (781) 329-5454
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3168 | MA | Primary |
Addresses
Primary practice location
738 High St
Westwood, MA 02090-2503
Mailing address
738 High St
Westwood, MA 02090-2503
Phone (781) 329-5454
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4014765-002 | Other | MA | CIGNA HEALTHCARE |
| 93921 | Other | MA | AETNA/US HEALTHCARE |
| 410022567 | Other | MA | RAILROAD RETIREMENT FUND |
| 720677 | Other | MA | TUFTS HEALTH PLANS |
| 15214 | Other | MA | HARVARD PILGRIM |
| 9761934 | Medicaid | MA | |
| W20038 | Other | MA | BLUE CROSS BLUE SHIELD |
| 024505659 | Other | MA | VISION SERVICE PLAN |
| 22-00367 | Other | MA | UNITED HEALTHCARE |
| 37955 | Other | MA | DAVIS VISION PLAN |
Other names 1
- Westwood Eyecare and Optical
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
738 High St
Westwood, MA 02090
Phone (781) 329-5454
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Westwood, MA
- NPI 1962885475
-
- Optometrist
- Westwood, MA
- NPI 1205408291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656460800000",
"number": "1205871928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 HIGH ST",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902503",
"telephone_number": "781-329-5454",
"fax_number": "781-329-7813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "738 HIGH ST",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902503",
"telephone_number": "781-329-5454",
"fax_number": "781-329-7813"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIUM EYE CARE, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-17",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A",
"authorized_official_last_name": "LAVALLEE",
"authorized_official_first_name": "CORY",
"authorized_official_title_or_position": "OD, OWNER",
"authorized_official_telephone_number": "781-329-5454",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "3168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "4014765-002",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/US HEALTHCARE",
"identifier": "93921",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD RETIREMENT FUND",
"identifier": "410022567",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLANS",
"identifier": "720677",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "15214",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9761934",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W20038",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICE PLAN",
"identifier": "024505659",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "22-00367",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION PLAN",
"identifier": "37955",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Westwood Eyecare and Optical",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Westwood Eyecare and Optical",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Westwood, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.