NPIMap

Organization Active NPI

Eye Associates of Somerville Inc.

Doing business as Alan Titelbaum

  • Optometrist
  • Somerville, MA
National Provider Identifier
1457491300
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2955 Issued in MA
Legal business name
EYE ASSOCIATES OF SOMERVILLE INC.
Doing business as
Alan Titelbaum
Practice address
174 Broadway
Somerville, MA 02145-3129
Phone
(617) 666-1800
Fax
(617) 628-4930
NPI assigned
Feb 8, 2007
Last updated
Oct 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Dr. Alan Richard Titelbaum, O.D.NPI 1851351100
Title
Optometrist
Phone
(617) 666-1800

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 2955 MA Primary

Addresses

Primary practice location

174 Broadway
Somerville, MA 02145-3129

Mailing address

174 Broadway
Somerville, MA 02145-3129
Phone (617) 666-1800

Other identifiers 1

IdentifierTypeStateIssuer
9707310MedicaidMA

Other names 1

  • ALAN TITELBAUM Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090210000034 MA Part B Supplier - Clinic/Group Practice 6608931506 Receives reassigned benefits from 4 practitioners
Practice locations: Somerville, MA
O20100930016149 MA DME Supplier - Physician - Optometrist 6608931506 Practice locations: Somerville, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Associates of Somerville Inc.174 Broadway, Somerville, MA 02145-3129(617) 666-1800 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jun 27, 2001

National Provider Directory

National Provider Directory

Locations

174 Broadway
Somerville, MA 02145
Phone (617) 666-1800

Practitioners & affiliated clinicians

Practitioners 7

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1457491300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453129",
            "telephone_number": "617-666-1800",
            "fax_number": "617-628-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453129",
            "telephone_number": "617-666-1800",
            "fax_number": "617-628-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF SOMERVILLE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "TITELBAUM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "617-666-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9707310",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALAN TITELBAUM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.