Lisa Ann Traveis, O.D.
Individual provider Active NPI Optometrist · Ipswich, MA
NPI 1619956794 · NPPES record last updated Jun 20, 2013
Key facts
- NPI
- 1619956794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- MA3308 (MA)
- Practice address
- 21 Market Street
Ste. 100
Ipswich, MA 01938 - Phone
- (978) 356-3015
- Fax
- (978) 356-7525
- NPI assigned
- Jan 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- 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 PC
Practice addresses (Care Compare)
39 Green St
Newburyport, MA 01950-2652
Phone (978) 465-8761
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111128000211 | MA | Practitioner - Optometry | 6709050958 |
Reassigns benefits to 1 organization Practice locations: Ipswich, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA3308 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appleton Eye Associates P.C. | Optometrist | Current |
Accepting new patients |
| Appleton Eye Associates PC | Optometrist | Current |
Accepting new patients |
| Appleton Eye Associates P.C. | Optometrist | Past |
Accepting new patients |
| Appleton Eye Associates PC | Optometrist | Past |
Accepting new patients |
Locations
39 Green St
Newburyport, MA 01950
Phone (978) 465-8761
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3308 | MA | |
| Optometrist | 152W00000X | MA3308 | MA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 732784 | Other | MA | TUFTS ID # |
Other providers in Ipswich, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.