Individual provider Active NPI

Joseph Martin Stamm, O.D.

  • Optometrist
  • Worcester, MA
National Provider Identifier
1295704559
Registry record updated Dec 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5210 Issued in MA
Practice address
10 Lincoln SQ
Worcester, MA 01608-1135
Phone
(508) 373-5830
Fax
(508) 519-5512
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV-004197 NY
Optometrist 152W00000X 5210 MA Primary

Addresses

Primary practice location

10 Lincoln SQ
Worcester, MA 01608-1135

Mailing address

10 Lincoln Square
Worcester, MA 01608-1135
Phone (508) 373-5830

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
I20170719001823 MA Practitioner - Optometry 5698941433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1982
Medicare assignment
May accept Medicare assignment
Group practices
McPhs UniversityGroup PAC ID 2365682713, 19 clinicians

Practice addresses (Care Compare)

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV-004197NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
McPhs University Optometrist CurrentSince Jul 3, 2018 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Dec 31, 2018 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Dec 31, 2018 Accepting new patients
Leominster Family Eyecare PLLC Optometrist PastSince Jul 3, 2018 Accepting new patients

Locations

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5607

10 Lincoln Sq
Rm 112G
Worcester, MA 01608

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

Organizations & group practices 4

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576972800000",
    "number": "1295704559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQUARE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMM",
        "first_name": "JOSEPH",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV-004197",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.