Active NPI
Leo Carl Denatale Jr., OD
- Optometrist
- Belmont, MA
National Provider Identifier
1548367238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2899
- Practice address
- 334 Trapelo Rd
Belmont, MA 02478 - Phone
- (617) 484-4851
- Fax
- (617) 484-4852
- NPI assigned
- Sep 17, 2006
- 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 | 2899 | MA | Primary |
Addresses
Primary practice location
334 Trapelo Rd
Belmont, MA 02478
Mailing address
334 Trapelo Rd
Belmont, MA 02478
Phone (617) 484-4851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0343668 | Medicaid | MA |
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 |
|---|---|---|---|
| 2899 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548367238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "334 TRAPELO RD",
"city": "BELMONT",
"state": "MA",
"postal_code": "02478",
"telephone_number": "617-484-4851",
"fax_number": "617-484-4852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 TRAPELO RD",
"city": "BELMONT",
"state": "MA",
"postal_code": "02478",
"telephone_number": "617-484-4851",
"fax_number": "617-484-4852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENATALE",
"first_name": "LEO",
"middle_name": "CARL",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "2899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0343668",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.