Individual provider Active NPI

William Joseph Ryan III, O.D.

  • Optometrist
  • Tyngsboro, MA
National Provider Identifier
1487761680
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3137 Issued in MA
Practice address
440 Middlesex Rd
Tyngsboro, MA 01879-1070
Phone
(978) 649-3880
Fax
(978) 649-4708
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3137 MA Primary

Addresses

Primary practice location

440 Middlesex Rd
Tyngsboro, MA 01879-1070

Mailing address

560 E Broadway
Haverhill, MA 01830-2423
Phone (978) 373-6701

Other identifiers 1

IdentifierTypeStateIssuer
110016064MedicaidMA

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
I20080324000049 MA Practitioner - Optometry 6800972472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sudbury Vision Associates,IncGroup PAC ID 3870681745, 2 clinicians

Practice addresses (Care Compare)

435 Boston Post Rd
Sudbury, MA 01776-3000
Phone (978) 443-7121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sudbury Vision Associates,Inc. Optometrist CurrentSince Oct 4, 2009 Accepting new patients

Locations

435 Boston Post Rd
Sudbury, MA 01776
Phone (978) 443-7121

440 Middlesex Rd
Tyngsboro, MA 01879
Phone (978) 649-3880

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1487761680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 E BROADWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302423",
            "telephone_number": "978-373-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MIDDLESEX RD",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018791070",
            "telephone_number": "978-649-3880",
            "fax_number": "978-649-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110016064",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyngsboro, MA

Sources for this page

Verify at the official NPI Registry.