Individual provider Active NPI

Minsheng Yuan, OD

  • Optometrist
  • Quincy, MA
National Provider Identifier
1275938284
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5061 Issued in MA
Practice address
88 Holmes St
Quincy, MA 02171-2431
Phone
(617) 318-3200
Fax
(617) 457-6600
NPI assigned
Nov 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 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 5061 MA Primary

Addresses

Primary practice location

88 Holmes St
Quincy, MA 02171-2431

Mailing address

88 Holmes Street, South Cove Community Health Center
Quincy, MA 02171
Phone (617) 318-3200

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
I20150331001260 MA Practitioner - Optometry 0840516878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 S St
Boston, MA 02111-2826
Phone (617) 521-6700

88 Holmes St
Quincy, MA 02171-2431
Phone (617) 318-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Cove Community Health Center, Inc. CurrentSince Apr 12, 2017 Accepting new patients
South Cove Community Health Center, Inc. CurrentSince Apr 12, 2017 Accepting new patients

Locations

145 South St
Boston, MA 02111
Phone (617) 521-6700

88 Holmes St
Quincy, MA 02171
Phone (617) 318-3200

Interoperability endpoints

  • Direct secure messaging: minsheng.yuan.p1@direct.northsuburbaneye.nextgenshare.com

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": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1275938284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 HOLMES STREET, SOUTH COVE COMMUNITY HEALTH CENTER",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02171",
            "telephone_number": "617-318-3200",
            "fax_number": "617-457-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HOLMES ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712431",
            "telephone_number": "617-318-3200",
            "fax_number": "617-457-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUAN",
        "first_name": "MINSHENG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-03",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.