Raffaele A Petrosino, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3862 Issued in MA

Practice address

22 Yale Ave
Wakefield, MA 01880-2309

Phone

(781) 245-1871

Fax

(781) 245-7963

NPI assigned

Jul 10, 2006

Last updated

Jan 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raffaele a Petrosino

  • Optometrist
  • Wakefield, MA
  • NPI 1932384179
  NPD (past) Authorized official
• Clearsight Vision Care LLC

  • Optometrist
  • Wakefield, MA
  • NPI 1679300057
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1326072810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 YALE AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802309",
            "telephone_number": "781-245-1871",
            "fax_number": "781-245-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 YALE AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802309",
            "telephone_number": "781-245-1871",
            "fax_number": "781-245-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "RAFFAELE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "32916",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "152-122",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "755438",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0369349",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MA",
            "identifier": "W16034",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy E. Perkus, OTR/L
• Priscilla Perry, OTR/L
• Peter J. Violette O.D.,P.C.
• Angela Lee Peters
• Mary Joan Peterson, LICSW
• Lance Michael Petty
• Phillip B Aubin DDS PC (Wakefield Orthodontic Care)
• Stephanie B Pincince
• Kathryn Elaine Pinkney, PHARMD
• Molly Pitman, CCC-SLP

• Optometrist in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.