Individual provider Active NPI

Michael O'Neil, O.D.

  • Optometrist
  • Groton, MA
National Provider Identifier
1407038656
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4278 Issued in MA
Practice address
140 Main St
Groton, MA 01450-1271
Phone
(978) 448-5172
Fax
(978) 448-6353
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4278 MA Primary

Addresses

Primary practice location

140 Main St
Groton, MA 01450-1271

Mailing address

140 Main St
Groton, MA 01450-1271
Phone (978) 448-5172

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
I20090512000075 MA Practitioner - OptometryPractitioner - Other (Physician) 9032185905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 Main St
Groton, MA 01450-1271
Phone (978) 448-5172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4278MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nashoba Vision Associates Inc Optometrist CurrentSince Feb 24, 2004 Accepting new patients
Michael O'Neil OD Optometrist PastSince Jan 1, 2008 Accepting new patients

Locations

140 Main St
Groton, MA 01450
Phone (978) 448-5172

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.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1407038656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MAIN ST",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014501271",
            "telephone_number": "978-448-5172",
            "fax_number": "978-448-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MAIN ST",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014501271",
            "telephone_number": "978-448-5172",
            "fax_number": "978-448-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, MA

Sources for this page

Verify at the official NPI Registry.