Organization Active NPI

Boston Vision Network One

  • Ophthalmology Physician
  • Brookline, MA
National Provider Identifier
1679228738
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BOSTON VISION NETWORK ONE
Practice address
24 Webster PL
Brookline, MA 02445-7937
Phone
(617) 202-2020
NPI assigned
Feb 17, 2022
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Samir A Melki, MDNPI 1407838295
Title
Medical Director
Phone
(617) 202-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

24 Webster PL
Brookline, MA 02445-7937

Mailing address

24 Webster PL
Brookline, MA 02445-7937
Phone (617) 202-2020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jarroyo@bostonvision.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220510001608 MA Part B Supplier - Clinic/Group Practice 6608253877 Receives reassigned benefits from 1 practitioner
Practice locations: Burlington, MA; Wellesley Hills, MA; Milford, MA; Medford, MA; Lawrence, MA; Brookline, MA; Andover, MA

National Provider Directory

National Provider Directory

Locations

172 Cambridge St
Burlington, MA 01803
Phone (701) 272-4944

204 Worcester St
Wellesley Hls, MA 02481
Phone (617) 566-0062

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1679228738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON VISION NETWORK ONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "MELKI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "617-202-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jarroyo@bostonvision.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "24 Webster Pl",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024457937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.