Individual provider Active NPI

Debra O'Donnell Cohen, O.D.

  • Optometrist
  • Plymouth, MA
National Provider Identifier
1245307834
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3787 Issued in MA
Practice address
300 Colony Place Rd
Plymouth, MA 02360-7235
Phone
(508) 830-3443
Fax
(508) 830-3443
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3787 MA Primary

Addresses

Primary practice location

300 Colony Place Rd
Plymouth, MA 02360-7235

Mailing address

300 Colony Place Rd
Plymouth, MA 02360-7235
Phone (508) 830-3443

Other identifiers 3

IdentifierTypeStateIssuer
0002295OtherMAGROUP P TAN
1053503912OtherGROUP NPI
1245307834OtherNPI

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
I20070208000416 MA Practitioner - Optometry 7315949070 Reassigns benefits to 1 organization
Practice locations: Hanover, MA; Plymouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
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)

200 Westgate Dr
Brockton, MA 02301-1810
Phone (508) 587-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3787MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Aug 11, 2019 Accepting new patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Aug 11, 2019 Accepting new patients
Barnstable Eye PC Optometrist Past Accepting new patients

Locations

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

200 Westgate Dr
Brockton, MA 02301
Phone (508) 584-8758

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1245307834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COLONY PLACE RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607235",
            "telephone_number": "508-830-3443",
            "fax_number": "508-830-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLONY PLACE RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607235",
            "telephone_number": "508-830-3443",
            "fax_number": "508-830-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "DEBRA",
        "middle_name": "O'DONNELL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP P TAN",
            "identifier": "0002295",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1053503912",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245307834",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.