NPIMap

Organization Active NPI

North Shore Eye Specialists

  • Optometrist
  • Danvers, MA
National Provider Identifier
1669593620
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3725 Issued in MA
Legal business name
NORTH SHORE EYE SPECIALISTS
Practice address
85 Constitution LN
Suite 100C
Danvers, MA 01923-3694
Phone
(978) 774-7033
Fax
(978) 774-0341
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Dr. William Moser Prentiss, O.D.
Title
Optometrist
Phone
(978) 774-7033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3725 MA Primary

Addresses

Primary practice location

85 Constitution LN
Suite 100C
Danvers, MA 01923-3694

Mailing address

85 Constitution LN
Suite 100C
Danvers, MA 01923-3694
Phone (978) 774-7033

Other identifiers 6

IdentifierTypeStateIssuer
0392316MedicaidMA
W20356OtherMABLUE CROSS BLUE SHEILD
0035493OtherMANEIGHBORHOOD HEALTH PLAN
151089OtherMAHARVARD PILGRIM
2252OtherMAFALLON
755413OtherMATUFTS

National Provider Directory

National Provider Directory

Locations

85 Constitution Ln
Ste 100C
Danvers, MA 01923
Phone (978) 774-5510

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1669593620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CONSTITUTION LN",
            "address_2": "SUITE 100C",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233694",
            "telephone_number": "978-774-7033",
            "fax_number": "978-774-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 CONSTITUTION LN",
            "address_2": "SUITE 100C",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233694",
            "telephone_number": "978-774-7033",
            "fax_number": "978-774-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE EYE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "PRENTISS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MOSER",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "978-774-7033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0392316",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "W20356",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0035493",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "151089",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "2252",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "755413",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.