Organization Active NPI

Gordon Eye Associates, Inc

  • Optometrist
  • Lexington, MA
National Provider Identifier
1295997674
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA4079 Issued in MA
Legal business name
GORDON EYE ASSOCIATES, INC
Practice address
47 Waltham St
Lexington, MA 02421-5406
Phone
(781) 674-1400
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Dr. Yale G Shriber, O.D.NPI 1306923776
Title
President
Phone
(781) 674-1400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X MA4079 MA Primary

Addresses

Primary practice location

47 Waltham St
Lexington, MA 02421-5406

Mailing address

47 Waltham St
Lexington, MA 02421-5406
Phone (781) 674-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100709000800 MA Part B Supplier - Clinic/Group Practice 1254463201 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1295997674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024215406",
            "telephone_number": "781-674-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024215406",
            "telephone_number": "781-674-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON EYE ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "SHRIBER",
        "authorized_official_first_name": "YALE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-674-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA4079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.