Individual provider Active NPI

Tina S Cleary

  • Retina Specialist (Ophthalmology) Physician
  • Boston, MA
National Provider Identifier
1649243221
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
220298 Issued in MA
Practice address
50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone
(617) 367-4800
Fax
(617) 723-7028
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 220298 MA
Retina Specialist (Ophthalmology) Physician 207WX0107X 220298 MA Primary

Addresses

Primary practice location

50 Staniford St
Suite 600
Boston, MA 02114-2517

Mailing address

50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone (617) 367-4800

Other identifiers 3

IdentifierTypeStateIssuer
2074664MedicaidMA
A3720702OtherMAPTAN
J28155OtherMABCBS MA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Cleary.Tina.OCB@direct.partners.masshiway.net Health Information Exchange (HIE)

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
I20040810000776 MA Practitioner - Ophthalmology 2769454719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Southwestern Medical School at Dallas, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Consultants of Boston IncGroup PAC ID 4789651498, 68 clinicians

Practice addresses (Care Compare)

50 Staniford St
Suite 600
Boston, MA 02114-2539
Phone (617) 367-4800

Hospital & facility affiliations

  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Boston, Inc. Ophthalmology Current Accepting new patients
Ophthalmic Consultants of Boston, Inc Ophthalmology CurrentSince Jul 6, 2004 Accepting new patients
Ophthalmic Consultants of Boston, Inc. Ophthalmology CurrentSince Jul 6, 2004 Accepting new patients
Pratt Ophthalmology Associates Inc Ophthalmology Past Accepting new patients
John Gurley, MD, PC Ophthalmology Past Accepting new patients
The General Hospital Corporation Past Accepting new patients

Locations

50 Staniford St
Ste 600
Boston, MA 02114
Phone (617) 367-4800

104 Endicott St
Ste 303
Danvers, MA 01923
Phone (978) 524-0050

282 Route 130
Sandwich, MA 02563
Phone (508) 427-3720

Interoperability endpoints

  • Direct secure messaging: cleary.tina.ocb@direct.partners.masshiway.net

Organizations & group practices 6

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1649243221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-367-4800",
            "fax_number": "617-723-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-367-4800",
            "fax_number": "617-723-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "TINA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "220298",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MA",
            "license": "220298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2074664",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "A3720702",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J28155",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cleary.Tina.OCB@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "50 Staniford St",
            "address_2": "Suite 600",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021142517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.