Individual provider Active NPI

Robert A Freedman, MD

  • Ophthalmology Physician
  • Salem, MA
National Provider Identifier
1598878738
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
37309 Issued in MA
Practice address
400 Highland Ave
Suite 20
Salem, MA 01970-1783
Phone
(978) 744-1177
Fax
(978) 910-0125
NPI assigned
Aug 15, 2006
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 37309 MA Primary

Addresses

Primary practice location

400 Highland Ave
Suite 20
Salem, MA 01970-1783

Mailing address

400 Highland Ave
Suite 20
Salem, MA 01970-1783
Phone (978) 744-1177

Other identifiers 2

IdentifierTypeStateIssuer
9745637MedicaidMA
1700086352OtherMAGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050630000502 MA Practitioner - Ophthalmology 2163468042 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center of the North Shore, LLC Ophthalmology CurrentSince Mar 15, 2010 Accepting new patients
Eye Center of the North Shore, LLC CurrentSince Mar 15, 2010 Accepting new patients
Robert a. Freedman, M.D. P.C Ophthalmology PastSince Sep 1, 2007 Accepting new patients

Locations

400 Highland Ave
Ste 20
Salem, MA 01970
Phone (978) 744-1177

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1598878738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "SUITE 20",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701783",
            "telephone_number": "978-744-1177",
            "fax_number": "978-910-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "SUITE 20",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701783",
            "telephone_number": "978-744-1177",
            "fax_number": "978-910-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "37309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9745637",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1700086352",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.