Dana Agnes, O.D.
Individual provider Active NPI Optometrist · Waltham, MA
NPI 1235124389 · NPPES record last updated Dec 31, 2018
Key facts
- NPI
- 1235124389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 5275 (MA)
- Practice address
- 52 2ND Ave Ste 2500
Waltham, MA 02451-1252 - Phone
- (781) 487-2200
- Fax
- (781) 487-5717
- NPI assigned
- Sep 14, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5275 | MA | MD | Mental Health Counselor |
| 1821 | NC | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyeoptix OD, PA | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1821 | NC | |
| Optometrist | 152W00000X | 5275 | MA | Yes |
Addresses
Primary practice location
52 2ND Ave Ste 2500
Waltham, MA 02451-1252
Mailing address
3 Sunday Woods Rd
Weston, MA 02493-1249
Phone (781) 907-7723
Other practice location 1
1960 Randolph Rd
Charlotte, NC 28207-1102
Phone (704) 716-2020
Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.