Individual provider Active NPI

Deborah Lynn McCoy, M.D.

  • Ophthalmology Physician
  • Lexington, MA
National Provider Identifier
1336144419
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
10684 Issued in NH
Practice address
21 Worthen Rd
Lexington, MA 02421-4835
Phone
(781) 862-1620
Fax
(781) 863-9416
NPI assigned
Jun 16, 2005
Last updated
Jun 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 10684 NH Primary
Ophthalmology Physician 207W00000X 204565 MA

Addresses

Primary practice location

21 Worthen Rd
Lexington, MA 02421-4835

Mailing address

21 Worthen Rd
Lexington, MA 02421-4835
Phone (781) 862-1620

Other identifiers 2

IdentifierTypeStateIssuer
2115808MedicaidMA
30200412MedicaidNH

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000219 MA Practitioner - Ophthalmology 3870486475 Reassigns benefits to 2 organizations
Practice locations: Lexington, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10684NHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Eye Associates, Inc. Ophthalmology CurrentSince Jan 3, 2006 Accepting new patients
Lexington Eye Associates, Inc Ophthalmology CurrentSince Jan 3, 2006 Accepting new patients
Emerson Hospital Current Accepting new patients
Lexington Eye Associates - Bid Ophthalmology CurrentSince Jan 14, 2015 Accepting new patients

Locations

21 Worthen Rd
Lexington, MA 02421
Phone (617) 862-1620

Interoperability endpoints

  • Direct secure messaging: mccoy.deborah.epho@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1336144419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1620",
            "fax_number": "781-863-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1620",
            "fax_number": "781-863-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NH",
            "license": "10684",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "204565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115808",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200412",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.