Individual provider Active NPI

Mary Keenan

  • Optician
  • Boston, MA
National Provider Identifier
1245599356
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
4786 Issued in MA
Practice address
681 Tremont St
Boston, MA 02118-1281
Phone
(617) 391-0088
Fax
(617) 391-0068
NPI assigned
May 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 4786 MA Primary

Addresses

Primary practice location

681 Tremont St
Boston, MA 02118-1281

Mailing address

681 Tremont St
Boston, MA 02118-1281
Phone (617) 391-0088

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1245599356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181281",
            "telephone_number": "617-391-0088",
            "fax_number": "617-391-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181281",
            "telephone_number": "617-391-0088",
            "fax_number": "617-391-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MA",
            "license": "4786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.