Organization Active NPI

Med Rac's

  • Ophthalmology Physician
  • Quincy, MA
National Provider Identifier
1356610828
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
78177 Issued in MA
Legal business name
MED RAC'S
Practice address
300 Congress Street
Suite 201
Quincy, MA 02169
Phone
(781) 733-3809
Fax
(617) 471-7041
NPI assigned
Dec 29, 2011
Last updated
Dec 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Ryan Alton Edco
Title
Ceo
Phone
(781) 733-3809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 78177 MA Primary

Addresses

Primary practice location

300 Congress Street
Suite 201
Quincy, MA 02169

Mailing address

300 Congress Street
Suite 201
Quincy, MA 02169
Phone (781) 733-3809

Other identifiers 1

IdentifierTypeStateIssuer
9705554MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1356610828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CONGRESS STREET",
            "address_2": "SUITE 201",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "781-733-3809",
            "fax_number": "617-471-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CONGRESS STREET",
            "address_2": "SUITE 201",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "781-733-3809",
            "fax_number": "617-471-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED RAC'S",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "EDCO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ALTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "781-733-3809"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "78177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9705554",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.