Individual provider Active NPI

Henry Richard Valentine, O.D.

  • Optometrist
  • Leominster, MA
National Provider Identifier
1477760163
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2612 Issued in MA
Practice address
80 Erdman Way
205
Leominster, MA 01453-1840
Phone
(978) 696-5674
Fax
(978) 400-7836
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2612 MA Primary

Addresses

Primary practice location

80 Erdman Way
205
Leominster, MA 01453-1840

Mailing address

80 Erdman Way
205
Leominster, MA 01453-1840
Phone (978) 696-5674

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
I20050603000113 MA Practitioner - Optometry 7214970086 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Leominster, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christian Iyore IncGroup PAC ID 5294112884, 3 clinicians

Practice addresses (Care Compare)

80 Erdman Way
Suite 205
Leominster, MA 01453-1840
Phone (978) 590-0126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2612MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valentine Eye Group Current Accepting new patients
Christian Iyore Inc Optometrist CurrentSince Aug 15, 2022 Accepting new patients

Locations

80 Erdman Way
#205
Leominster, MA 01453
Phone (978) 696-5674

80 Erdman Way
Ste 205
Leominster, MA 01453
Phone (978) 590-0126

Practitioners & affiliated clinicians

Practitioners 1

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1477760163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY",
            "address_2": "205",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531840",
            "telephone_number": "978-696-5674",
            "fax_number": "978-400-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY",
            "address_2": "205",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531840",
            "telephone_number": "978-696-5674",
            "fax_number": "978-400-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "HENRY",
        "middle_name": "RICHARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.