Active NPI
Matthew J. Modderno, O.D.
- Optometrist
- Norwood, MA
National Provider Identifier
1649330390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4353
- Practice address
- 138 Nahatan St.
Norwood, MA 02062 - Phone
- (781) 255-1505
- Fax
- (781) 255-1507
- NPI assigned
- Dec 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4353 | MA | Primary |
Addresses
Primary practice location
138 Nahatan St.
Norwood, MA 02062
Mailing address
138 Nahatan St.
Norwood, MA 02062
Phone (781) 255-1505
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
138 Nahatan St
Norwood, MA 02062-4252
Phone (781) 255-1505
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4353 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modderno Eyecare, P.C. | Optometrist | Current | Accepting new patients |
| For Eyes Optical of PA | Past | Accepting new patients |
Locations
138 Nahatan St
Norwood, MA 02062
Phone (781) 255-1502
Organizations & group practices 2
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.
-
- Optometrist
- Norwood, MA
- NPI 1578815528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649330390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 NAHATAN ST.",
"city": "NORWOOD",
"state": "MA",
"postal_code": "02062",
"telephone_number": "781-255-1505",
"fax_number": "781-255-1507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 NAHATAN ST.",
"city": "NORWOOD",
"state": "MA",
"postal_code": "02062",
"telephone_number": "781-255-1505",
"fax_number": "781-255-1507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODDERNO",
"first_name": "MATTHEW",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "4353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwood, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.