Active NPI
Eddie Hornedo Jr., LDO
- Optician
- Revere, MA
National Provider Identifier
1407347800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 6016
- Practice address
- 339 Squire Rd
Revere, MA 02151-4309 - Phone
- (781) 289-5900
- NPI assigned
- May 22, 2018
- Last updated
- Jan 11, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 6016 | MA | Primary |
Addresses
Primary practice location
339 Squire Rd
Revere, MA 02151-4309
Mailing address
38 Murray St
Peabody, MA 01960-2327
Phone (978) 390-0022
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 |
|---|---|---|---|
| 6016 | MA | MD | Mental Health Counselor |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1407347800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 MURRAY ST",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602327",
"telephone_number": "978-390-0022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 SQUIRE RD",
"city": "REVERE",
"state": "MA",
"postal_code": "021514309",
"telephone_number": "781-289-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORNEDO",
"first_name": "EDDIE",
"name_suffix": "Jr.",
"credential": "LDO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-22",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "MA",
"license": "6016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.