Individual provider Active NPI

Patti A Landry, OD

  • Optometrist
  • Cambridge, MA
National Provider Identifier
1689647232
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3069 Issued in MA
Practice address
77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301
Phone
(617) 253-4351
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3069 MA Primary

Addresses

Primary practice location

77 Mass Ave
Medical E23-395
Cambridge, MA 02139-4301

Mailing address

PO Box 425789
Medical E23-395
Cambridge, MA 02142-0015
Phone (617) 253-4351

Other identifiers 1

IdentifierTypeStateIssuer
W15805OtherMABLUE CROSS

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
I20040308001078 MA Practitioner - Optometry 1254229693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Institute of TechnologyGroup PAC ID 5597658666, 55 clinicians

Practice addresses (Care Compare)

25 Carleton St
Cambridge, MA 02142-1323
Phone (617) 258-6896

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3069MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince Aug 7, 2008 Accepting new patients

Locations

77 Massachusetts Ave
#E23308
Cambridge, MA 02139
Phone (617) 258-5332

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689647232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425789",
            "address_2": "MEDICAL E23-395",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021420015",
            "telephone_number": "617-253-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MASS AVE",
            "address_2": "MEDICAL E23-395",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394301",
            "telephone_number": "617-253-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "PATTI",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "W15805",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.