Organization Active NPI

Agawam Eye Associates, Inc

  • Optometrist
  • Feeding Hills, MA
National Provider Identifier
1609031046
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3134 3119 Issued in MA
Legal business name
AGAWAM EYE ASSOCIATES, INC
Practice address
656 Springfield St
Feeding Hills, MA 01030-2130
Phone
(413) 789-2106
NPI assigned
Jul 24, 2008
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Dr. Richard W Gallerani, O.D.NPI 1699753624
Title
President
Phone
(413) 789-2106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3134 3119 MA Primary

Addresses

Primary practice location

656 Springfield St
Feeding Hills, MA 01030-2130

Mailing address

656 Springfield St
Feeding Hills, MA 01030-2130
Phone (413) 789-2106

Other identifiers 1

IdentifierTypeStateIssuer
0352683MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000706 MA Part B Supplier - Clinic/Group Practice 2567526395 Receives reassigned benefits from 2 practitioners
Practice locations: Feeding Hills, MA

National Provider Directory

National Provider Directory

Locations

656 Springfield St
Feeding Hills, MA 01030
Phone (413) 789-2106

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1609031046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 SPRINGFIELD ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010302130",
            "telephone_number": "413-789-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 SPRINGFIELD ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010302130",
            "telephone_number": "413-789-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAWAM EYE ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "GALLERANI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-789-2106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3134   3119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0352683",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Feeding Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.