Individual provider Active NPI

Lisa Ann Traveis, O.D.

  • Optometrist
  • Ipswich, MA
National Provider Identifier
1619956794
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA3308 Issued in MA
Practice address
21 Market Street
Ste. 100
Ipswich, MA 01938
Phone
(978) 356-3015
Fax
(978) 356-7525
NPI assigned
Jan 17, 2006
Last updated
Jun 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3308 MA
Optometrist 152W00000X MA3308 MA Primary

Addresses

Primary practice location

21 Market Street
Ste. 100
Ipswich, MA 01938

Mailing address

21 Market Street
Ste. 100
Ipswich, MA 01938
Phone (978) 356-3015

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
I20111128000211 MA Practitioner - Optometry 6709050958 Reassigns benefits to 1 organization
Practice locations: Ipswich, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appleton Eye Associates PCGroup PAC ID 0840367975, 9 clinicians

Practice addresses (Care Compare)

39 Green St
Newburyport, MA 01950-2652
Phone (978) 465-8761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3308MAMDRegistered Dietitian
MA3308MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Appleton Eye Associates PC Optometrist CurrentSince Sep 8, 2020 Accepting new patients
Appleton Eye Associates P.C. Optometrist CurrentSince Sep 8, 2020 Accepting new patients
Appleton Eye Associates PC Optometrist PastSince Oct 11, 2020 Accepting new patients
Appleton Eye Associates P.C. Optometrist PastSince Mar 16, 2021 Accepting new patients

Locations

39 Green St
Newburyport, MA 01950
Phone (978) 465-8761

Organizations & group practices 4

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1619956794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MARKET STREET",
            "address_2": "STE. 100",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "01938",
            "telephone_number": "978-356-3015",
            "fax_number": "978-356-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MARKET STREET",
            "address_2": "STE. 100",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "01938",
            "telephone_number": "978-356-3015",
            "fax_number": "978-356-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVEIS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3308",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA3308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ipswich, MA

Sources for this page

Verify at the official NPI Registry.