Active NPI
Eric Moulton, O.D., PH.D
- Pediatric Optometrist
- Boston, MA
National Provider Identifier
1669912283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Optometrist
- License
- 5201
- Practice address
- 300 Longwood Ave
Department of Ophthalmology, Fegan 4
Boston, MA 02115-5724 - Phone
- (617) 355-6401
- NPI assigned
- Mar 1, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5201 | MA | |
| Pediatric Optometrist | 152WP0200X | 5201 | MA | Primary |
Addresses
Primary practice location
300 Longwood Ave
Department of Ophthalmology, Fegan 4
Boston, MA 02115-5724
Mailing address
300 Longwood Ave
Department of Ophthalmology, Fegan 4
Boston, MA 02115-5724
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201 | MA | MD | Pediatric Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Hospital Boston | Past | Accepting new patients | |
| Children'S Hospital Pediatric Associates, Inc | Past | Accepting new patients |
Interoperability endpoints
- emoulton67623@direct.bostonchildrens.org
Organizations & group practices 3
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.
-
- Ophthalmology Physician
- Boston, MA
- NPI 1770679045
-
- Pediatrics Physician
- Boston, MA
- NPI 1457306664
-
- Children's Hospital
- Boston, MA
- NPI 1770741530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1669912283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "DEPARTMENT OF OPHTHALMOLOGY, FEGAN 4",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "DEPARTMENT OF OPHTHALMOLOGY, FEGAN 4",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "ERIC",
"credential": "O.D., PH.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-01",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "5201",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "MA",
"license": "5201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.