Active NPI
Vivienne Therese Kong, OD
- Optometrist
- Chelmsford, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3434
- Practice address
- 19 Village SQ
Chelmsford, MA 01824-2712 - Phone
- (978) 256-5600
- Fax
- (978) 703-0250
- NPI assigned
- Aug 16, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 3434 | MA | Primary |
Addresses
Primary practice location
19 Village SQ
Chelmsford, MA 01824-2712
Mailing address
Massachusetts Eye Associates PC
19 Village Square
Chelmsford, MA 01824-2712
Phone (978) 256-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0354228 | Medicaid | MA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111114000329 | MA | Practitioner - Optometry | 3779757505 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts Eye Associates PC | Current | Accepting new patients | |
| Massachusetts Eye Associates PC | Optometrist | Current | Accepting new patients |
Locations
19 Village Sq
Chelmsford, MA 01824
Phone (978) 256-5600
33 Bartlett St
Ste 101
Lowell, MA 01852
Phone (978) 256-5600
500 Clark Rd
Ste 3B
Tewksbury, MA 01876
Phone (978) 256-5600
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Chelmsford, MA
- NPI 1912999095
MA, Optometrist
-
- Eyewear Supplier
- Chelmsford, MA
- NPI 1295930949
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Massachusetts Eye Associates PC
Practice addresses (Care Compare)
19 Village SQ
Chelmsford, MA 01824-2712
Phone (978) 256-5600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1366434441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MASSACHUSETTS EYE ASSOCIATES PC",
"address_2": "19 VILLAGE SQUARE",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018242712",
"telephone_number": "978-256-5600",
"fax_number": "978-703-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 VILLAGE SQ",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018242712",
"telephone_number": "978-256-5600",
"fax_number": "978-703-0250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "VIVIENNE",
"middle_name": "THERESE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-16",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "3434",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0354228",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chelmsford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.