Sullivan Optometry, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2233 Issued in MA

Legal business name

SULLIVAN OPTOMETRY, PC

Practice address

34 Pope St
Hudson, MA 01749-2182

Phone

(978) 562-7976

Fax

(978) 562-4807

NPI assigned

Jan 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Garrett F. Sullivan, O.D.NPI 1255363321

Title

Owner/Optometrist

Phone

(978) 562-7976

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Garrett F. Sullivan, O.D.

  • Optometrist
  • Hudson, MA
  • NPI 1255363321
  Medicare reassignment Care Compare group NPD Authorized official
• Daniel G Sullivan, OD

  • Optometrist
  • Hudson, MA
  • NPI 1811057441
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1538346226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 POPE ST",
            "city": "HUDSON",
            "state": "MA",
            "postal_code": "017492182",
            "telephone_number": "978-562-7976",
            "fax_number": "978-562-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 POPE ST",
            "city": "HUDSON",
            "state": "MA",
            "postal_code": "017492182",
            "telephone_number": "978-562-7976",
            "fax_number": "978-562-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN OPTOMETRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "978-562-7976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9764054",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "0004395",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W20431",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NHIC",
            "identifier": "W21104",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indira Rezende Souza
• Corinne Elizabeth Spangler-Baccam, MA, LMHC. CEIS
• Destiny Rhonye Sparks-Forges
• Suba Dental Dba Hudson Dental Care
• Victoria Maria Pontes Sueiro
• Daniel G Sullivan, OD
• Garrett F. Sullivan, O.D.
• Amanda Sutherland
• Victoria Swanson
• Tara Sweeney

• Optometrist in Hudson, MA
• Providers in Hudson, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.