Amanda Lee Gannon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5477 Issued in MA

Practice address

495 Cabot St Ste 1
Beverly, MA 01915-2515

Phone

(978) 921-5000

Fax

(978) 921-5003

NPI assigned

May 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Massachusetts P CGroup PAC ID 1951661297, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agannon021374@myeyedr.emadirect.md

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.

• Myeyedr Optometry of Massachusetts P C

  • Optometrist
  • Amherst, MA
  • NPI 1124534946
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Massachusetts P C

  • Optometrist
  • Burlington, MA
  • NPI 1659901569
  NPD
• Myeyedr Optometry of Massachusetts P C

  • Optometrist
  • North Andover, MA
  • NPI 1922971415
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1659946093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CABOT ST STE 1",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152515",
            "telephone_number": "978-921-5000",
            "fax_number": "978-921-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Washington St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024811711",
            "country_code": "US",
            "telephone_number": "781-263-7360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gallant
• Robert B. Gallant, PH.D.
• Jaipal Singh Gandhi, MD
• Mackenzie May Ganier
• Donald G Ganim, M.D.
• Kathleen Rose Gannon
• Victoria H Gantz, NP
• Wilmer J Garcia
• Garden City Pediatric Assoc, LLC
• Lilit Garibyan, M.D, PH.D.

• Optometrist in Beverly, MA
• Providers in Beverly, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.

Verify at the official NPI Registry.