Active NPI
Steven J. Brodhead, O.D.
- Optometrist
- Newton, MA
National Provider Identifier
1255498168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3287
- Practice address
- 697 Washington St
Newton, MA 02458-1260 - Phone
- (617) 527-1418
- Fax
- (617) 964-1417
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3287 | MA | Primary |
Addresses
Primary practice location
697 Washington St
Newton, MA 02458-1260
Mailing address
697 Washington St
Newton, MA 02458-1260
Phone (617) 527-1418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0354449 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3287 | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Eye Care of Newton, LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Newton, MA
- NPI 1164967949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1255498168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "697 WASHINGTON ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581260",
"telephone_number": "617-527-1418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "697 WASHINGTON ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581260",
"telephone_number": "617-527-1418",
"fax_number": "617-964-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODHEAD",
"first_name": "STEVEN",
"middle_name": "J.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "3287",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0354449",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.