Individual provider Active NPI

Robert E. Segool, O.D.

  • Optometrist
  • Burlington, MA
National Provider Identifier
1356448419
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4503 Issued in MA
Practice address
112 Winn St
Burlington, MA 01803-3109
Phone
(781) 270-2345
Fax
(781) 623-2444
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 4503 MA Primary

Addresses

Primary practice location

112 Winn St
Burlington, MA 01803-3109

Mailing address

112 Winn St
Burlington, MA 01803-3109
Phone (781) 270-2345

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
I20050915000824 MA Practitioner - Optometry 3577596956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Massachusetts Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 Winn St
Burlington, MA 01803-3109
Phone (781) 270-2345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4503MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert E. Segool, Optometrist. Inc. Optometrist CurrentSince Jul 28, 2005 Accepting new patients

Locations

24 Mall Rd
Burlington, MA 01803
Phone (781) 229-8100

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1356448419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WINN ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033109",
            "telephone_number": "781-270-2345",
            "fax_number": "781-623-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WINN ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033109",
            "telephone_number": "781-270-2345",
            "fax_number": "781-623-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGOOL",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.