Individual provider Active NPI

Katherine F Coffey, OD

  • Optometrist
  • Quincy, MA
National Provider Identifier
1679617104
Registry record updated Jan 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3497 Issued in MA
Practice address
104 Quarry St Ste 3
Quincy, MA 02169
Phone
(617) 481-6650
Fax
(617) 302-4713
NPI assigned
Feb 17, 2007
Last updated
Jan 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3497 MA Primary

Addresses

Primary practice location

104 Quarry St Ste 3
Quincy, MA 02169

Mailing address

104 Quarry St Ste 3
Quincy, MA 02169-4175
Phone (617) 481-6650

Other identifiers 4

IdentifierTypeStateIssuer
0005432OtherNHP
725467OtherTUFTS
W15874OtherBCBS
152010OtherHPHC

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
I20090527000169 MA Practitioner - Optometry 9234288069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Washington St
Wellesley, MA 02481-1706
Phone (781) 263-7360

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3497MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Dec 18, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Dec 18, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Past Accepting new patients

Locations

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

104 Quarry St
Ste 3
Quincy, MA 02169
Phone (617) 481-6650

1 Washington St
Ste 101
Wellesley Hills, MA 02481
Phone (617) 332-1471

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1679617104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 QUARRY ST STE 3",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694175",
            "telephone_number": "617-481-6650",
            "fax_number": "617-302-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 QUARRY ST STE 3",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-481-6650",
            "fax_number": "617-302-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "KATHERINE",
        "middle_name": "F",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0005432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "725467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W15874",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "152010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.