Individual provider Active NPI

Marc O'Meara, RD

  • Registered Dietitian
  • Chestnut Hill, MA
National Provider Identifier
1366464398
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1179 Issued in MA
Practice address
25 Boylston St
Suite 312
Chestnut Hill, MA 02467-1715
Phone
(978) 337-1059
Fax
(978) 486-3768
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1179 MA Primary

Addresses

Primary practice location

25 Boylston St
Suite 312
Chestnut Hill, MA 02467-1715

Mailing address

136 Mill Rd
Littleton, MA 01460-1548
Phone (978) 486-3578

Other identifiers 1

IdentifierTypeStateIssuer
LD0203OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040109000339 MA Practitioner - Registered Dietitian Or Nutrition Professional 5092615815 Practice locations: Chestnut Hill, MA

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Vermont College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 Boylston St
Suite 312
Chestnut Hill, MA 02467-1710
Phone (978) 337-1059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1179MAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1366464398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MILL RD",
            "city": "LITTLETON",
            "state": "MA",
            "postal_code": "014601548",
            "telephone_number": "978-486-3578",
            "fax_number": "978-486-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BOYLSTON ST",
            "address_2": "SUITE 312",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671715",
            "telephone_number": "978-337-1059",
            "fax_number": "978-486-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MEARA",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LD0203",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.