Active NPI
Christina La, OD
- Optometrist
- Waltham, MA
National Provider Identifier
1366212367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5681
- Practice address
- 400 5TH Ave Ste 510
Waltham, MA 02451-8734 - Phone
- (781) 890-9922
- NPI assigned
- Jan 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5681 | MA | Primary |
Addresses
Primary practice location
400 5TH Ave Ste 510
Waltham, MA 02451-8734
Mailing address
400 5TH Ave Ste 510
Waltham, MA 02451-8734
Phone (781) 890-9922
Other practice location 1
50 Burlington Mall Rd Ste 101
Burlington, MA 01803-4527
Phone (781) 404-7992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5681 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1366212367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 5TH AVE STE 510",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024518734",
"telephone_number": "781-890-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 5TH AVE STE 510",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024518734",
"telephone_number": "781-890-9922"
}
],
"practiceLocations": [
{
"address_1": "50 Burlington Mall Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018034527",
"country_code": "US",
"telephone_number": "781-404-7992",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LA",
"first_name": "CHRISTINA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-02",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "5681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.