Individual provider Active NPI

Jeffrey L. Taveras, MD

  • Ophthalmology Physician
  • Cambridge, MA
National Provider Identifier
1558474874
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
59546 Issued in MA
Practice address
75 Mount Auburn St
Huhs
Cambridge, MA 02138-4960
Phone
(617) 495-2068
Fax
(617) 496-0540
NPI assigned
Aug 17, 2006
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 59546 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Huhs
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Huhs
Cambridge, MA 02138-4960
Phone (617) 495-2068

Other identifiers 2

IdentifierTypeStateIssuer
J07279OtherMABC/BS OF MA
059546OtherMATUFTS HEALTH PLAN

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000894 MA Practitioner - Ophthalmology 8022065507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tufts University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1563 Mass Ave
Cambridge, MA 02138-2903
Phone (617) 495-4414

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 496-8700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59546MAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
President & Fellows of Harvard College CurrentSince Jun 1, 1988 Accepting new patients
President and Fellows of Harvard College CurrentSince Jun 1, 1988 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1558474874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HUHS",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-2068",
            "fax_number": "617-496-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HUHS",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-2068",
            "fax_number": "617-496-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "59546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA",
            "identifier": "J07279",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "059546",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.