Donald Bruce Ninneman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4092 Issued in MA

Practice address

101 Independence Mall Way
Lens Crafters
Kingston, MA 02364-3048

Phone

(781) 588-7029

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dynamic Eye Care, Inc.

  • Optometrist
  • Kingston, MA
  • NPI 1093905085
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1669545323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BLUFF AVE",
            "city": "SWANSEA",
            "state": "MA",
            "postal_code": "027771644",
            "telephone_number": "508-822-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 INDEPENDENCE MALL WAY",
            "address_2": "LENS CRAFTERS",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023643048",
            "telephone_number": "781-588-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINNEMAN",
        "first_name": "DONALD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "152257",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0313131",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W16148",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy A Murray, LCSW
• Neighborhood Housing Services of the South Shore
• Neighborhood Housing Services of the South Shore
• New England Sound LLC
• Next Level Psychological Services, LLC
• Rachel Woodbury Novak, LICSW
• Edward Obrien
• Corianne Oliver
• Jennifer Moran Pace, PHYSICAL THERAPIST
• Steven Michael Paradis, COTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.