NPIMap

Organization Active NPI

Boston University Eye Associates, Inc.

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1285691337
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BOSTON UNIVERSITY EYE ASSOCIATES, INC.
Practice address
850 Harrison Ave # Acc-3
Boston, MA 02118-4001
Phone
(617) 414-4020
Fax
(617) 414-4028
NPI assigned
May 1, 2006
Last updated
Oct 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Stephen P Christiansen, M.D., MPHNPI 1134156680
Title
Chairman
Phone
(508) 823-7473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

850 Harrison Ave # Acc-3
Boston, MA 02118-4001

Mailing address

850 Harrison Ave # Acc-3
Boston, MA 02118-4001
Phone (617) 414-4020

Other identifiers 2

IdentifierTypeStateIssuer
M15524OtherMABCBS
9766162MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000649 MA Part B Supplier - Clinic/Group Practice 4789571225 Receives reassigned benefits from 29 practitioners
Practice locations: Boston, MA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

720 Harrison Ave
#10
Boston, MA 02118
Phone (617) 638-8350

22 Christy Dr
Ste 1
Brockton, MA 02301
Phone (508) 588-3060

511 W Grove St
Middleboro, MA 02346
Phone (508) 923-3427

2005 Bay St
Ste 206
Taunton, MA 02780
Phone (508) 822-2266

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1285691337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE # ACC-3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-4020",
            "fax_number": "617-414-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE # ACC-3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-4020",
            "fax_number": "617-414-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON UNIVERSITY EYE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "508-823-7473",
        "authorized_official_credential": "M.D., MPH"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M15524",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9766162",
            "state": "MA"
        }
    ],
    "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 Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.