Individual provider Active NPI

Andrea Lynn Carr, O.D

  • Optometrist
  • Fitchburg, MA
National Provider Identifier
1487675955
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4509 Issued in MA
Practice address
326 Nichols Rd
Fitchburg, MA 01420-1914
Phone
(978) 878-8100
Fax
(978) 878-8442
NPI assigned
Jul 21, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4509 MA Primary

Addresses

Primary practice location

326 Nichols Rd
Fitchburg, MA 01420-1914

Mailing address

326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100

Other identifiers 1

IdentifierTypeStateIssuer
0799998MedicaidMA

Other names 1

  • Andrea Lynn Bastarache Other name

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
I20050809000161 MA Practitioner - Optometry 1355370586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Connections, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Community Health Connections, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Community Health Connections, Inc. Current Accepting new patients
Vision Source of Amherst and Greenfield Optometrist PastSince May 27, 2012 Accepting new patients

Locations

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

Interoperability endpoints

  • Direct secure messaging: andrea.carr.p1@direct.chcfhc.nextgenshare.com

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1487675955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0799998",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BASTARACHE",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fitchburg, MA

Sources for this page

Verify at the official NPI Registry.