Individual provider Active NPI

Tiffany Pasqua, OD

  • Optometrist
  • Jamaica Plain, MA
National Provider Identifier
1215668942
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
X Issued in MA
Practice address
150 S Huntington Ave
Jamaica Plain, MA 02130-4817
Phone
(857) 364-5796
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 X MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Jamaica Plain, MA 02130-4817

Mailing address

150 S Huntington Ave
Jamaica Plain, MA 02130-4817
Phone (857) 364-5796

Other practice location 1

10 Overlook Ridge Dr Unit 330
Malden, MA 02148-4765
Phone (860) 385-3537

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
I20230713002013 MA Practitioner - Optometry 5799145454 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
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

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

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

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
XMAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Optometrist Current Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Atrius Health, Inc. Past Accepting new patients

Locations

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

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

26 City Hall Mall
Medford, MA 02155
Phone (781) 306-5100

Interoperability endpoints

  • Direct secure messaging: tpasquaod371958@direct.atrius.masshiway.net

Organizations & group practices 4

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": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1215668942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-5796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Overlook Ridge Dr Unit 330",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021484765",
            "country_code": "US",
            "telephone_number": "860-385-3537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASQUA",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "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": "MA",
            "license": "X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.