Individual provider Active NPI

Domenic M Strazzulla, M.D.

  • Ophthalmology Physician
  • Quincy, MA
National Provider Identifier
1609859990
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
50129 Issued in MA
Practice address
500 Congress St
Suite 1a-1
Quincy, MA 02169-0908
Phone
(617) 770-1505
Fax
(617) 479-6832
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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 50129 MA Primary

Addresses

Primary practice location

500 Congress St
Suite 1a-1
Quincy, MA 02169-0908

Mailing address

500 Congress St
Suite 1a-1
Quincy, MA 02169-0908
Phone (617) 770-1505

Other identifiers 1

IdentifierTypeStateIssuer
6191266MedicaidMA

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
I20050324000717 MA Practitioner - OphthalmologyPractitioner - Optometry 1355397167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Optometry
Education
Boston University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Congress St
Suite 1A1
Quincy, MA 02169-0917
Phone (617) 770-1505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery279

National Provider Directory

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

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.

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1609859990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CONGRESS ST",
            "address_2": "SUITE 1A-1",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690908",
            "telephone_number": "617-770-1505",
            "fax_number": "617-479-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CONGRESS ST",
            "address_2": "SUITE 1A-1",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690908",
            "telephone_number": "617-770-1505",
            "fax_number": "617-479-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAZZULLA",
        "first_name": "DOMENIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "50129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6191266",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.