Individual provider Active NPI

Aliya Zul Jiwani, MD

  • Retina Specialist (Ophthalmology) Physician
  • Brockton, MA
National Provider Identifier
1417218397
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
266020 Issued in MA
Practice address
179 Quincy St
Brockton, MA 02302-2966
Phone
(508) 894-0400
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD15679 RI
Retina Specialist (Ophthalmology) Physician 207WX0107X 036152658 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X 266020 MA Primary
Ophthalmology Physician 207W00000X 266020 MA

Addresses

Primary practice location

179 Quincy St
Brockton, MA 02302-2966

Mailing address

1400 Main St Apt 510
Weymouth, MA 02190-1471

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190116003630 MA Practitioner - Ophthalmology 9032353750 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036152658ILMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eye Centers Inc Ophthalmology CurrentSince Jan 14, 2019 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Mar 1, 2022 Accepting new patients
TLC Eyewear Inc. PastSince Mar 1, 2022 Accepting new patients

Locations

179 Quincy St
Brockton, MA 02302
Phone (508) 427-7700

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

179 Quincy St
Ste 3
Brockton, MA 02302
Phone (508) 565-3252

1741 President Ave
Fall River, MA 02720
Phone (508) 674-2020

500 Faunce Corner Rd
Ste 110
North Dartmouth, MA 02747
Phone (508) 717-0270

Interoperability endpoints

  • Direct secure messaging: aliya.jiwani@direct.signature.masshiway.net

Organizations & group practices 3

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1417218397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MAIN ST APT 510",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022966",
            "telephone_number": "508-894-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIWANI",
        "first_name": "ALIYA",
        "middle_name": "ZUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "MD15679",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036152658",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MA",
            "license": "266020",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "266020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.