Individual provider Active NPI

Susan M Kwaiter-Sadler, O.D.

  • Optometrist
  • Medfield, MA
National Provider Identifier
1629100144
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4167-TP Issued in MA
Practice address
67 West St
Medfield, MA 02052-1577
Phone
(508) 359-9969
NPI assigned
Mar 10, 2007
Last updated
Aug 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4167-TP MA Primary

Addresses

Primary practice location

67 West St
Medfield, MA 02052-1577

Mailing address

67 West St
Medfield, MA 02052-1577
Phone (508) 359-9969

Other identifiers 1

IdentifierTypeStateIssuer
W16253OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4167-TPMAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ilana Orelowitz, O.D. Inc Optometrist PastSince Aug 1, 2006 Accepting new patients

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, 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": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1629100144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 WEST ST",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020521577",
            "telephone_number": "508-359-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WEST ST",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020521577",
            "telephone_number": "508-359-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAITER-SADLER",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-10",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4167-TP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W16253",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.