Individual provider Active NPI

Armina Raeisian, OD

  • Optometrist
  • Somerville, MA
National Provider Identifier
1477934776
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33363 Issued in CA
Practice address
294 Highland Ave
Apt #3
Somerville, MA 02144-3271
Phone
(703) 629-8340
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33363 CA Primary

Addresses

Primary practice location

294 Highland Ave
Apt #3
Somerville, MA 02144-3271

Mailing address

2621 S Bristol St Ste 205
Santa Ana, CA 92704-5700
Phone (703) 629-8340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33363CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1477934776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST STE 205",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045700",
            "telephone_number": "703-629-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 HIGHLAND AVE",
            "address_2": "APT #3",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021443271",
            "telephone_number": "703-629-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAEISIAN",
        "first_name": "ARMINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.