Individual provider Active NPI

Shirley Salomon, OD

  • Optometrist
  • Boston, MA
National Provider Identifier
1336580901
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4969 Issued in MA
Practice address
33 Broad St
Boston, MA 02109
Phone
(617) 742-7200
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4969 MA Primary

Addresses

Primary practice location

33 Broad St
Boston, MA 02109

Mailing address

33 Broad St
Boston, MA 02109
Phone (617) 742-7200

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
I20131122000156 MA Practitioner - Optometry 9335375351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Massachusetts P CGroup PAC ID 1951661297, 57 clinicians

Practice addresses (Care Compare)

33 Broad St
Boston, MA 02109-4216
Phone (617) 742-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4969MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Past Accepting new patients

Locations

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

33 Broad St
Boston, MA 02109
Phone (617) 742-7200

1191 Chestnut St
Newton Upper Falls, MA 02464
Phone (617) 243-3937

104 Quarry St
Ste 3
Quincy, MA 02169
Phone (617) 481-6650

1 Washington St
Ste 101
Wellesley Hills, MA 02481
Phone (617) 332-1471

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1336580901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BROAD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109",
            "telephone_number": "617-742-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BROAD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109",
            "telephone_number": "617-742-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOMON",
        "first_name": "SHIRLEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.