Peter E Cerruti, OD
Individual provider Active NPI Optometrist · Lee, MA
NPI 1649286402 · NPPES record last updated Jun 9, 2008
Key facts
- NPI
- 1649286402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2184 (MA)
- Practice address
- 40 Franklin St
Lee, MA 01238-1630 - Phone
- (413) 243-0604
- Fax
- (413) 243-3939
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2184 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peter E. Cerruti O.D. | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2184 | MA | Yes |
Addresses
Primary practice location
40 Franklin St
Lee, MA 01238-1630
Mailing address
PO Box 399
Lee, MA 01238-0399
Phone (413) 243-0604
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0302678 | Medicaid | MA |
Other providers in Lee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.