Individual provider Active NPI

Alanna Tisdale, M.D., M.P.H.

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1235589144
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
289633 Issued in MA
Practice address
85 E Concord St FL 8
Boston, MA 02118-2335
Phone
(617) 638-4552
NPI assigned
Jun 21, 2016
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 289633 MA Primary
Neuro-ophthalmology Physician 207WX0109X 289633 MA

Addresses

Primary practice location

85 E Concord St FL 8
Boston, MA 02118-2335

Mailing address

85 E Concord St FL 8
Boston, MA 02118-2335
Phone (617) 638-4552

Other practice location 1

41 Mall Rd
Burlington, MA 01805-2335
Phone (781) 744-8000

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210925000070 MA Practitioner - Ophthalmology 0840588794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
289633MAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Internal Medicine Current Accepting new patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients

Locations

31 Mall Rd
Burlington, MA 01803
Phone (207) 317-1886

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

Interoperability endpoints

  • Direct secure messaging: atisdale232946@direct.bilh.masshiway.net

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1235589144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 E CONCORD ST FL 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182335",
            "telephone_number": "617-638-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E CONCORD ST FL 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182335",
            "telephone_number": "617-638-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018052335",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "ALANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.,  M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "289633",
            "primary": true
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "MA",
            "license": "289633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.