Individual provider Active NPI

Alia Nazer Khalaf, O.D.

  • Optometrist
  • Worcester, MA
National Provider Identifier
1689974792
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4826 Issued in MA
Practice address
10 Lincoln SQ
Worcester, MA 01608-1135
Phone
(508) 373-5802
Fax
(508) 373-5802
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4826 MA Primary

Addresses

Primary practice location

10 Lincoln SQ
Worcester, MA 01608-1135

Mailing address

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

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
I20110617000424 MA Practitioner - Optometry 6800074063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
May accept Medicare assignment
Group practices
McPhs UniversityGroup PAC ID 2365682713, 19 clinicians

Practice addresses (Care Compare)

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2022 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Apr 1, 2022 Accepting new patients
McPhs University Optometrist CurrentSince Nov 4, 2016 Accepting new patients
Leominster Family Eyecare PLLC Optometrist PastSince Nov 4, 2016 Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5607

10 Lincoln Sq
Rm 112G
Worcester, MA 01608

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

Organizations & group practices 4

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1689974792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "508-373-5802",
            "fax_number": "508-373-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALAF",
        "first_name": "ALIA",
        "middle_name": "NAZER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.