Active NPI
Mallory Miller, OD
- Optometrist
- Boston, MA
National Provider Identifier
1518693902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5555
- Practice address
- 77 N Washington St
Boston, MA 02114-1908 - Phone
- (617) 227-2010
- NPI assigned
- Jul 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5555 | MA | Primary |
Addresses
Primary practice location
77 N Washington St
Boston, MA 02114-1908
Mailing address
222 Beacon St Apt 12a
Boston, MA 02116-1354
Phone (724) 797-7926
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
77 N Washington St
Boston, MA 02114-1908
Phone (617) 227-2010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul M Cangiano Inc | Optometrist | Current | Accepting new patients |
Locations
77 N Washington St
Boston, MA 02114
Phone (617) 227-2010
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": "1658880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1518693902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 BEACON ST APT 12A",
"city": "BOSTON",
"state": "MA",
"postal_code": "021161354",
"telephone_number": "724-797-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 N WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021141908",
"telephone_number": "617-227-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MALLORY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-27",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "5555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.