Individual provider Active NPI

Samantha Susan Vadakin

  • Optometrist
  • Northborough, MA
National Provider Identifier
1477237055
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5623 Issued in MA
Practice address
345 Main St
Northborough, MA 01532-1607
Phone
(508) 832-8322
Fax
(508) 832-7662
NPI assigned
Jun 14, 2023
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030.0133989 VT
Optometrist 152W00000X 5623 MA Primary

Addresses

Primary practice location

345 Main St
Northborough, MA 01532-1607

Mailing address

345 Main St
Northborough, MA 01532-1607
Phone (508) 832-8322

Other practice location 1

830 Chalkstone Ave
Providence, RI 02908-4734
Phone (401) 273-7100

Other practice location 2

10 Lincoln Sq
Worcester, MA 01608-1135
Phone (508) 373-5830

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
I20240320002371 MA Practitioner - Optometry 2163869611 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
McPhs UniversityGroup PAC ID 2365682713, 19 clinicians

Practice addresses (Care Compare)

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030.0133989VTMDOptometrist
5623MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Goswick Eye LLC Optometrist CurrentSince Feb 3, 2024 Accepting new patients
McPhs University Optometrist CurrentSince Sep 3, 2024 Accepting new patients
Leominster Family Eyecare PLLC Optometrist PastSince Sep 3, 2024 Accepting new patients

Locations

345 Main St
Northborough, MA 01532
Phone (508) 832-4613

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5607

10 Lincoln Sq
Rm 112G
Worcester, MA 01608

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1477237055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAIN ST",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015321607",
            "telephone_number": "508-832-8322",
            "fax_number": "508-832-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MAIN ST",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015321607",
            "telephone_number": "508-832-8322",
            "fax_number": "508-832-7662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084734",
            "country_code": "US",
            "telephone_number": "401-273-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Lincoln Sq",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081135",
            "country_code": "US",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VADAKIN",
        "first_name": "SAMANTHA",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133989",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

Verify at the official NPI Registry.