Vicki Shangraw Kvedar, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

59738 Issued in MA

Practice address

467 Main St
Melrose, MA 02176-3856

Phone

(781) 662-2216

Fax

(781) 662-2297

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Boston University School of Medicine, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Specialty Eye Consultants, LLCGroup PAC ID 2264964774, 7 clinicians

Specialty Eye Consultants 2 LLCGroup PAC ID 4880115682, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvedar.vicki@elincdirect.org
• Direct secure messaging: vkvedar28736@tuftsmedicine.direct-ci.com
• Direct secure messaging: kvedar.vicki.ags@direct.partners.masshiway.net

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.

• Specialty Eye Consultants 2 LLC

  • Ophthalmology Physician
  • Reading, MA
  • NPI 1245079722
  Medicare reassignment Care Compare group NPD
• Specialty Eye Consultants LLC

  • Ophthalmology Physician
  • Reading, MA
  • NPI 1912753724
  Medicare reassignment Care Compare group NPD
• Mark a Latina LLC

  • Ophthalmology Physician
  • Reading, MA
  • NPI 1619413069
  Medicare reassignment NPD
• Mark a. Latina

  dba Advanced Glaucoma Specialists

  • Ophthalmology Physician
  • Reading, MA
  • NPI 1508839291
  Medicare reassignment NPD
• Advanced Glaucoma Specialists

  • Ophthalmology Physician
  • Reading, MA
  • NPI 1790014900
  NPD

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1316910953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GREY LN",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019401240",
            "telephone_number": "781-334-6316",
            "fax_number": "781-334-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763856",
            "telephone_number": "781-662-2216",
            "fax_number": "781-662-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVEDAR",
        "first_name": "VICKI",
        "middle_name": "SHANGRAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "59738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078418",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda L Kopnisky, PA-C
• Geraldine S. Koppenaal, RNCS
• Steven Ira Kornbleuth, MD
• Sybil Meg Kramer, MD
• Martha S Krikeles, MD
• Melissa M Lackey, D.M.D.,M.D.
• Mackenzie Lacroix, PA-C
• Josee Laplante, MD
• Lauren Larcano
• Rachel Erin Latta, PH.D.

• Ophthalmology Physician in Melrose, MA
• Providers in Melrose, MA by specialty
• Ophthalmology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.