Individual provider Active NPI

Jeffrey Weintraub, O.D.

  • Optometrist
  • Burlington, VT
National Provider Identifier
1508913500
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000276 Issued in VT
Practice address
30 Main St Ste 120
Burlington, VT 05401-8427
Phone
(802) 658-7610
Fax
(802) 864-0893
NPI assigned
Jan 4, 2007
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030-0000276 VT Primary

Addresses

Primary practice location

30 Main St Ste 120
Burlington, VT 05401-8427

Mailing address

30 Main St Ste 120
Burlington, VT 05401-8427
Phone (802) 658-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20070724000590 VT Practitioner - Optometry 4981705712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030-0000276VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobileyes Optometry Inc Optometrist CurrentSince Sep 2, 2024 Accepting new patients

Locations

218 Lower Mountain View Dr
Ste 2
Colchester, VT 05446
Phone (802) 654-7599

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, 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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1508913500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAIN ST STE 120",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018427",
            "telephone_number": "802-658-7610",
            "fax_number": "802-864-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAIN ST STE 120",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018427",
            "telephone_number": "802-658-7610",
            "fax_number": "802-864-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINTRAUB",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030-0000276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.