Individual provider Active NPI

Sandra Victor Daoud, OD

  • Optometrist
  • Canton, MA
National Provider Identifier
1235282377
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4299 Issued in MA
Practice address
95 Washington St
Ste 466
Canton, MA 02021-4008
Phone
(781) 821-1224
Fax
(877) 992-0275
NPI assigned
Jan 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4299 MA Primary

Addresses

Primary practice location

95 Washington St
Ste 466
Canton, MA 02021-4008

Mailing address

95 Washington St
Ste 466
Canton, MA 02021-4008
Phone (781) 821-1224

Other identifiers 1

IdentifierTypeStateIssuer
0338800MedicaidMA

Other names 1

  • Sandra Victor Zaki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4299MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Massachusetts Professional PC Optometrist CurrentSince Oct 16, 2023 Accepting new patients
Personal Eyes Inc Optometrist Past Accepting new patients
Eyes on Randolph LLC Optometrist PastSince Jun 1, 2023 Accepting new patients

Locations

94 N Main St
Mansfield, MA 02048
Phone (508) 339-3952

Organizations & group practices 3

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": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1235282377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "STE 466",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214008",
            "telephone_number": "781-821-1224",
            "fax_number": "877-992-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "STE 466",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214008",
            "telephone_number": "781-821-1224",
            "fax_number": "877-992-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAOUD",
        "first_name": "SANDRA",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0338800",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "ZAKI",
            "middle_name": "VICTOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.