Active NPI
Joseph R Donatelle, O.D.
- Optometrist
- Springfield, MA
National Provider Identifier
1548263981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2075
- Practice address
- 1268 Sumner Ave
Springfield, MA 01118-1770 - Phone
- (413) 782-5339
- Fax
- (413) 782-3050
- NPI assigned
- May 31, 2005
- Last updated
- Jan 29, 2008
- Sex
- Male
- 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 | 2075 | MA | Primary |
Addresses
Primary practice location
1268 Sumner Ave
Springfield, MA 01118-1770
Mailing address
1268 Sumner Ave
Springfield, MA 01118-1770
Phone (413) 782-5339
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2204082 | Other | MA | UNITED HEALTH CARE |
| 0012291 | Other | MA | NIEGHBORHOOD HEALTH PLAN |
| 207500 | Other | MA | CONNECTICARE |
| 11873 | Other | MA | HEALTH NEW ENGLAND |
| 1207562002 | Other | MA | CIGNA |
| 762249 | Other | MA | TUFTS |
| 988410 | Other | MA | NETWORK HEALTH |
| 5098016 | Other | MA | AETNA |
| 604061 | Other | MA | US HEALTHCARE |
| 0309001 | Medicaid | MA | |
| T59001 | Other | MA | PIONEER |
| W15240 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2075 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspen Enterprises, Inc. | Optometrist | Past | Accepting new patients |
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.
-
dba Springfield Optometric Associates
- Optometrist
- Springfield, MA
- NPI 1326123688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1548263981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1268 SUMNER AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011181770",
"telephone_number": "413-782-5339",
"fax_number": "413-782-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1268 SUMNER AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011181770",
"telephone_number": "413-782-5339",
"fax_number": "413-782-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONATELLE",
"first_name": "JOSEPH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "2075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2204082",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NIEGHBORHOOD HEALTH PLAN",
"identifier": "0012291",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "207500",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "11873",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1207562002",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "762249",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "988410",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5098016",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "604061",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0309001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIONEER",
"identifier": "T59001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W15240",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.