Individual provider Active NPI

Tiffany Lu, OD

  • Optometrist
  • Jamaica Plain, MA
National Provider Identifier
1609567189
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5594 Issued in MA
Practice address
615 Centre St
Jamaica Plain, MA 02130-2537
Phone
(617) 983-3937
NPI assigned
May 16, 2023
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5594 MA Primary

Addresses

Primary practice location

615 Centre St
Jamaica Plain, MA 02130-2537

Mailing address

215 Thomas Burgin Pkwy Unit 24
Quincy, MA 02169-4220

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
I20230724000329 MA Practitioner - Optometry 4688034689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Massachusetts Professional PCGroup PAC ID 6901282557, 44 clinicians

Practice addresses (Care Compare)

12 Eliot St
Cambridge, MA 02138-5824
Phone (617) 354-3303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5594MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David M Luria OD PC Optometrist CurrentSince May 10, 2023 Accepting new patients
Aeg Massachusetts Professional PC Optometrist CurrentSince Mar 21, 2025 Accepting new patients

Locations

15 Central St
Andover, MA 01810
Phone (978) 475-5252

12 Eliot St
Cambridge, MA 02138
Phone (617) 354-3303

615 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-3937

850 Chelmsford St
Lowell, MA 01851
Phone (978) 452-0127

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.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1609567189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 THOMAS BURGIN PKWY UNIT 24",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302537",
            "telephone_number": "617-983-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "TIFFANY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.