Individual provider Active NPI

Stephanie A Paris-Whitney, O.D.

  • Corneal and Contact Management Optometrist
  • Waltham, MA
National Provider Identifier
1265424758
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
3675 Issued in MA
Practice address
1601 Trapelo Rd
Suite 184
Waltham, MA 02451-7333
Phone
(781) 890-7797
Fax
(781) 890-2507
NPI assigned
Aug 19, 2005
Last updated
Aug 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3675 MA Primary

Addresses

Primary practice location

1601 Trapelo Rd
Suite 184
Waltham, MA 02451-7333

Mailing address

1601 Trapelo Rd
Suite 184
Waltham, MA 02451-7333
Phone (781) 890-7797

Other identifiers 6

IdentifierTypeStateIssuer
3442143OtherAETNA/US HEALTHCARE
42957Other1199 NATIONAL BENEFIT FUN
AA8378OtherHPHC
755280OtherTUFTS
7704123OtherCIGNA
W22020OtherMABCBS-MA

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
I20041012000808 MA Practitioner - Optometry 0042270357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Ejc Eyecare LLCGroup PAC ID 6901952134, 4 clinicians

Practice addresses (Care Compare)

289 Moody St
Waltham, MA 02453-5284
Phone (781) 894-0081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ejc Eyecare, LLC CurrentSince Jun 28, 2009 Accepting new patients
Pro Optical Past Accepting new patients

Locations

289 Moody St
Waltham, MA 02453
Phone (781) 894-0081

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.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1265424758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 TRAPELO RD",
            "address_2": "SUITE 184",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024517333",
            "telephone_number": "781-890-7797",
            "fax_number": "781-890-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TRAPELO RD",
            "address_2": "SUITE 184",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024517333",
            "telephone_number": "781-890-7797",
            "fax_number": "781-890-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS-WHITNEY",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MA",
            "license": "3675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "3442143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199 NATIONAL BENEFIT FUN",
            "identifier": "42957",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA8378",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "755280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7704123",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MA",
            "identifier": "W22020",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.