Individual provider Active NPI

Robert Michael Tieri, OD

  • Optometrist
  • Acton, MA
National Provider Identifier
1427038835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3015 Issued in MA
Practice address
465 Great Rd
Acton, MA 01720
Phone
(978) 266-0017
Fax
(978) 263-5700
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3015 MA Primary

Addresses

Primary practice location

465 Great Rd
Acton, MA 01720

Mailing address

PO Box 301
Maynard, MA 01754
Phone (978) 266-0017

Other identifiers 8

IdentifierTypeStateIssuer
W201575OtherCIGNA
0347299MedicaidMA
39879OtherDAVIS VISION
152084OtherMAHARVARD PILGRIM
702894OtherMATUFTS
1007735OtherAETNA
1007735OtherUS HEALTHCARE
W15588OtherMABLUE CROSS

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
I20100720000551 MA Practitioner - Optometry 3577695907 Reassigns benefits to 1 organization
Practice locations: Ayer, MA; Acton, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Eye Physicians and Surgeons, P.C.Group PAC ID 2466433032, 3 clinicians

Practice addresses (Care Compare)

190 Groton Rd
Suite 240
Ayer, MA 01432-1191
Phone (978) 772-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Golebiowski Eye Care LLC Optometrist PastSince Dec 1, 2022 Accepting new patients
Valley Eye Physicians and Surgeons, P.C. Past Accepting new patients

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427038835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "01754",
            "telephone_number": "978-266-0017",
            "fax_number": "978-263-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "01720",
            "telephone_number": "978-266-0017",
            "fax_number": "978-263-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERI",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "W201575",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347299",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "39879",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "152084",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "702894",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1007735",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "1007735",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "W15588",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.