Individual provider Active NPI

Nimira Samji, OD

  • Optometrist
  • Danvers, MA
National Provider Identifier
1235204694
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4108 Issued in MA
Practice address
139 Endicott St
Endicott Plaza
Danvers, MA 01923-2515
Phone
(978) 777-4700
Fax
(978) 750-0862
NPI assigned
Nov 21, 2006
Last updated
May 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010253 IL
Optometrist 152W00000X 4108 MA Primary

Addresses

Primary practice location

139 Endicott St
Endicott Plaza
Danvers, MA 01923-2515

Mailing address

139 Endicott St
Endicott Plaza
Danvers, MA 01923-2515
Phone (978) 777-4700

Other identifiers 5

IdentifierTypeStateIssuer
0335771MedicaidMA
346003017OtherILILLINOIS CONTROLLED SUBSTANCE
4108OtherMAMASSACHUSETTS OPTOMETRY LICENSE
046010253OtherILILLINOIS OPTOMETRY LICENSE
W16375OtherMABCBS

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
I20190104000601 MA Practitioner - Optometry 7315283868 Reassigns benefits to 3 organizations
I20230822000359 NH Practitioner - Optometry 7315283868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass Optometric Associates, PLLCGroup PAC ID 0648362442, 50 clinicians

Practice addresses (Care Compare)

1 Highland Ave
3B
Malden, MA 02148-6603
Phone (781) 321-9039

139 Endicott St
Danvers, MA 01923-4803
Phone (978) 777-4700

652 Lafayette Rd
Unit 3
Seabrook, NH 03874-4346
Phone (603) 414-0269

700 Boston Rd
Billerica, MA 01821-5316
Phone (978) 667-0481

90 Middlesex Tpke
Burlington, MA 01803-4920
Phone (781) 229-0434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080NHMDAddiction (Substance Use Disorder) Counselor
046010253ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Jan 30, 2023 Accepting new patients
Appleton Eye Associates PC Optometrist Current Accepting new patients
Appleton Eye Associates P.C. Optometrist CurrentSince Feb 4, 2022 Accepting new patients
Exeter Eye Associates, LLC Optometrist CurrentSince Nov 1, 2018 Accepting new patients
Optometric Providers of New Hampshire, PLLC Optometrist CurrentSince Jul 9, 2023 Accepting new patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Jan 30, 2023 Accepting new patients
Optometric Providers of New Hampshire, PLLC Optometrist CurrentSince Jul 9, 2023 Accepting new patients

Locations

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

37 Newbury St
Boston, MA 02116
Phone (617) 437-1070

139 Endicott St
Danvers, MA 01923
Phone (978) 646-8930

39 Green St
Newburyport, MA 01950
Phone (978) 465-8761

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

652 Lafayette Rd
Unit 3
Seabrook, NH 03874
Phone (603) 414-0269

Organizations & group practices 7

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1235204694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 ENDICOTT ST",
            "address_2": "ENDICOTT PLAZA",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232515",
            "telephone_number": "978-777-4700",
            "fax_number": "978-750-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 ENDICOTT ST",
            "address_2": "ENDICOTT PLAZA",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232515",
            "telephone_number": "978-777-4700",
            "fax_number": "978-750-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMJI",
        "first_name": "NIMIRA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010253",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0335771",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS CONTROLLED SUBSTANCE",
            "identifier": "346003017",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS OPTOMETRY LICENSE",
            "identifier": "4108",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS OPTOMETRY LICENSE",
            "identifier": "046010253",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W16375",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.