Active NPI
Liqun Yuan
- Optometrist
- Cambridge, MA
National Provider Identifier
1477328391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5665
- Practice address
- 603 Concord Ave Ste B
Cambridge, MA 02138-1380 - Phone
- (617) 945-2906
- NPI assigned
- Nov 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5665 | MA | Primary |
Addresses
Primary practice location
603 Concord Ave Ste B
Cambridge, MA 02138-1380
Mailing address
603 Concord Ave Ste B
Cambridge, MA 02138-1380
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5665 | MA | MD | Speech-Language Pathologist |
Organizations & group practices 1
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.
-
- Optometrist
- Cambridge, MA
- NPI 1235688557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1477328391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 CONCORD AVE STE B",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 CONCORD AVE STE B",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381380",
"telephone_number": "617-945-2906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUAN",
"first_name": "LIQUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "5665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.