NPIMap

Organization Active NPI

Advanced Eyecare Specialists, P.C.

  • Optometrist
  • Falmouth, MA
National Provider Identifier
1437386166
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3456 Issued in MA
Legal business name
ADVANCED EYECARE SPECIALISTS, P.C.
Practice address
352 Main St
Falmouth, MA 02540-3175
Phone
(508) 444-8691
Fax
(508) 444-8693
NPI assigned
Jun 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Authorized official

Name
Dr. Timothy Jon Sajban, O.D.NPI 1942244835
Title
President
Phone
(508) 280-2479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 3456 MA Primary
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 3456 MA

Addresses

Primary practice location

352 Main St
Falmouth, MA 02540-3175

Mailing address

619 Wakeby Rd
Marstons Mills, MA 02648-1623
Phone (508) 280-2479

Other identifiers 4

IdentifierTypeStateIssuer
0371751MedicaidMA
0011817OtherMAMEDICARE (PTAN)
423858OtherMAMEDICARE ID-TYPE UNSPECIFIED
1942244835OtherNPI- INDIVIDUAL NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090904000233 MA Part B Supplier - Clinic/Group Practice 6406901966 Receives reassigned benefits from 1 practitioner
Practice locations: Falmouth, MA

National Provider Directory

National Provider Directory

Locations

352 Main St
Unit 1
Falmouth, MA 02540
Phone (508) 280-2479

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1437386166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 WAKEBY RD",
            "city": "MARSTONS MILLS",
            "state": "MA",
            "postal_code": "026481623",
            "telephone_number": "508-280-2479",
            "fax_number": "508-428-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 MAIN ST",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025403175",
            "telephone_number": "508-444-8691",
            "fax_number": "508-444-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-21",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "SAJBAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-280-2479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3456",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MA",
            "license": "3456",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0371751",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (PTAN)",
            "identifier": "0011817",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "423858",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- INDIVIDUAL NUMBER",
            "identifier": "1942244835",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.