Individual provider Active NPI

Ryan Christopher Racette, OD

  • Optometrist
  • Plymouth, MA
National Provider Identifier
1669998969
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5249 Issued in MA
Practice address
212 S Meadow Rd Unit 5C
Plymouth, MA 02360-5450
Phone
(774) 283-4005
Fax
(774) 374-2285
NPI assigned
Aug 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5249 MA Primary

Addresses

Primary practice location

212 S Meadow Rd Unit 5C
Plymouth, MA 02360-5450

Mailing address

212 S Meadow Rd Unit 5C
Plymouth, MA 02360-5450
Phone (774) 283-4005

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171019000562 MA Practitioner - Optometry 5193091122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 S Meadow Rd
Suite 5C
Plymouth, MA 02360-5450
Phone (774) 283-4005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Family Optometry LLC Optometrist CurrentSince Jun 3, 2019 Accepting new patients

Locations

212 S Meadow Rd
Ste 5C
Plymouth, MA 02360
Phone (774) 283-4005

212 S Meadow Rd
Unit 5C
Plymouth, MA 02360
Phone (774) 283-4005

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1669998969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S MEADOW RD UNIT 5C",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605450",
            "telephone_number": "774-283-4005",
            "fax_number": "774-374-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S MEADOW RD UNIT 5C",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605450",
            "telephone_number": "774-283-4005",
            "fax_number": "774-374-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACETTE",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.