Vivian Chung

Primary specialty

OptometristTaxonomy code 152W00000X

License

5328 Issued in MA

Practice address

289 Moody St
Waltham, MA 02453-5284

Phone

(781) 894-2127

Fax

(781) 894-1128

NPI assigned

Dec 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Ejc Eyecare LLCGroup PAC ID 6901952134, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ejc Eyecare, LLC

  dba Community Opticians

  • Optometrist
  • Waltham, MA
  • NPI 1235368275
  Medicare reassignment Care Compare group NPD
• Dr. Laura Anne Potvin, P.C.

  • Optometrist
  • Groveland, MA
  • NPI 1619985082
  Medicare reassignment NPD

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1225500135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 MOODY ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535284",
            "telephone_number": "781-894-2127",
            "fax_number": "781-894-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 MOODY ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535284",
            "telephone_number": "781-894-2127",
            "fax_number": "781-894-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jisoo Choi
• Christian M. Karavolas, D.D.S., P.C.
• Mary Teresa Christin, LICSW
• CHS Massachusetts Medical PC (AZ Health and Wellness Center)
• CHS of Waltham, Inc. (Maristhill Nursing & Rehabilitation Center)
• Weiyen Chung, M.A.
• Bonita Ann Ciambotti, LICSW
• Mattia Cianfrone
• Erica Marie Ciaramicoli
• Circle Care Services LLC

• Optometrist in Waltham, MA
• Providers in Waltham, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.