Individual provider Active NPI

Kristiana Micinoti, OD

  • Optometrist
  • Weymouth, MA
National Provider Identifier
1235867797
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5572 Issued in MA
Practice address
97 Libbey Pkwy
Weymouth, MA 02189-3110
Phone
(781) 331-3300
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5572 MA Primary

Addresses

Primary practice location

97 Libbey Pkwy
Weymouth, MA 02189-3110

Mailing address

31 Wollaston Ave
Quincy, MA 02170-2701
Phone (617) 955-2535

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829002367 MA Practitioner - Optometry 0941684799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

97 Libbey Industrial Pkwy
Suite 100
East Weymouth, MA 02189-3110
Phone (781) 331-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Boston, Inc Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Ophthalmic Consultants of Boston, Inc. Current Accepting new patients
Ophthalmic Consultants of Boston, Inc. Current Accepting new patients
Ophthalmic Consultants of Boston, Inc. CurrentSince Aug 8, 2022 Accepting new patients

Locations

50 Staniford St
Ste 600
Boston, MA 02114
Phone (617) 367-4800

146 Church St
Pembroke, MA 02359
Phone (781) 826-2306

1900 Crown Colony Dr
Quincy, MA 02169
Phone (617) 472-5242

282 Route 130
Sandwich, MA 02563
Phone (508) 427-3720

97 Libbey Industrial Pkwy
Ste 100
Weymouth, MA 02189
Phone (781) 331-3300

Interoperability endpoints

  • Direct secure messaging: micinoti.kristiana.ocb@direct.partners.masshiway.net

Organizations & group practices 4

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": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1235867797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WOLLASTON AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021702701",
            "telephone_number": "617-955-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 LIBBEY PKWY",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893110",
            "telephone_number": "781-331-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICINOTI",
        "first_name": "KRISTIANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.