Individual provider Active NPI

Yale Gordon Shriber, O.D.

  • Optometrist
  • Lexington, MA
National Provider Identifier
1306923776
Registry record updated Nov 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4079 Issued in MA
Practice address
47 Waltham St
Lexington, MA 02421-5406
Phone
(781) 674-1400
Fax
(781) 674-1308
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4079 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
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
I20040109000105 MA Practitioner - Optometry 6406756386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon Eye Associates, Inc Optometrist CurrentSince Jun 3, 2010 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259280000000",
    "number": "1306923776",
    "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",
            "fax_number": "781-674-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIBER",
        "first_name": "YALE",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2009-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.