Individual provider Active NPI

Jamie Robert Delugan, OD

  • Optometrist
  • Braintree, MA
National Provider Identifier
1265460968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3116 Issued in MA
Practice address
340 Wood Rd
Suite 2020
Braintree, MA 02184-2401
Phone
(781) 794-2200
Fax
(781) 794-2239
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3116 MA Primary

Addresses

Primary practice location

340 Wood Rd
Suite 2020
Braintree, MA 02184-2401

Mailing address

340 Wood Rd
Suite 2020
Braintree, MA 02184-2401
Phone (781) 794-2200

Other identifiers 1

IdentifierTypeStateIssuer
0391778MedicaidMA

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
I20110218000056 MA Practitioner - Optometry 3577624022 Reassigns benefits to 2 organizations
Practice locations: Quincy, MA; Braintree, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Eye Physicians and Surgeons IncGroup PAC ID 9335288836, 2 clinicians
Tchao Eye Associates LLCGroup PAC ID 4587004007, 2 clinicians

Practice addresses (Care Compare)

1261 Furnace Brook Pkwy
Quincy, MA 02169-4762
Phone (617) 770-0011

340 Wood Rd
Suite 2020
Braintree, MA 02184-2404
Phone (781) 794-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3116MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tchao Eye Associates LLC Optometrist CurrentSince Mar 18, 2024 Accepting new patients
Associated Eye Physicians & Surgeons Inc CurrentSince Dec 1, 2011 Accepting new patients

Locations

340 Wood Rd
Ste 2020
Braintree, MA 02184
Phone (781) 794-2200

1261 Furnace Brook Pkwy
Ste 15
Quincy, MA 02169
Phone (617) 248-9482

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, 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265460968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "address_2": "SUITE 2020",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401",
            "telephone_number": "781-794-2200",
            "fax_number": "781-794-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "address_2": "SUITE 2020",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401",
            "telephone_number": "781-794-2200",
            "fax_number": "781-794-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUGAN",
        "first_name": "JAMIE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0391778",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.