Individual provider Active NPI

Ralph W. Eaves, O.D.

  • Optometrist
  • Hanover, MA
National Provider Identifier
1598850869
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA3123 Issued in MA
Practice address
1422 Washington Street
Hanover, MA 02339
Phone
(781) 826-8393
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MA3123 MA Primary

Addresses

Primary practice location

1422 Washington Street
Hanover, MA 02339

Mailing address

9 Fords Crossing
Norwell, MA 02061
Phone (781) 659-1853

Other identifiers 2

IdentifierTypeStateIssuer
W15640OtherMABC/BS OF MA
0352632MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000503 MA Practitioner - Optometry 1951432459

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA3123MAMDOptometrist
3123MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John J Lee OD PC Optometrist PastSince Apr 1, 2010 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1598850869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FORDS CROSSING",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "02061",
            "telephone_number": "781-659-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 WASHINGTON STREET",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "02339",
            "telephone_number": "781-826-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES",
        "first_name": "RALPH",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA3123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA",
            "identifier": "W15640",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0352632",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MA

Sources for this page

Verify at the official NPI Registry.