Organization Active NPI

Visionary Eye Care LLC

  • Optometrist
  • Leominster, MA
National Provider Identifier
1447349840
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3744 Issued in MA
Legal business name
VISIONARY EYE CARE LLC
Practice address
875 Merriam Ave
Suite 135
Leominster, MA 01453-1236
Phone
(978) 537-0202
Fax
(978) 537-0303
NPI assigned
Oct 12, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Dr. Sandra Yelen, O.D.NPI 1740260975
Title
Optometrist
Phone
(978) 537-0202

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3744 MA Primary

Addresses

Primary practice location

875 Merriam Ave
Suite 135
Leominster, MA 01453-1236

Mailing address

875 Merriam Ave
Suite 135
Leominster, MA 01453-1236
Phone (978) 537-0202

Other identifiers 1

IdentifierTypeStateIssuer
9750151MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000078 MA Part B Supplier - Clinic/Group Practice 1254399629 Receives reassigned benefits from 1 practitioner
Practice locations: Leominster, MA

National Provider Directory

National Provider Directory

Locations

875 Merriam Ave
Ste 127
Leominster, MA 01453
Phone (978) 537-0202

875 Merriam Ave
Ste 135
Leominster, MA 01453
Phone (978) 537-0202

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1447349840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MERRIAM AVE",
            "address_2": "SUITE 135",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531236",
            "telephone_number": "978-537-0202",
            "fax_number": "978-537-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MERRIAM AVE",
            "address_2": "SUITE 135",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531236",
            "telephone_number": "978-537-0202",
            "fax_number": "978-537-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "YELEN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "978-537-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9750151",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.