Organization Active NPI

Lexington Eye Associates-Bid

  • Optometrist
  • Lexington, MA
National Provider Identifier
1699228445
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LEXINGTON EYE ASSOCIATES-BID
Practice address
21 Worthen Rd
Lexington, MA 02421-4835
Phone
(781) 862-1620
Fax
(781) 863-9416
NPI assigned
Jul 28, 2016
Organization subpart
Yes
Parent organization
LEXINGTON EYE ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Jennifer P. Mullon, M.D.
Title
President
Phone
(781) 862-1620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

21 Worthen Rd
Lexington, MA 02421-4835

Mailing address

21 Worthen Rd
Lexington, MA 02421-4835
Phone (781) 862-1620

Other identifiers 1

IdentifierTypeStateIssuer
S100198299OtherMAMEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Lexington Eye Associates - Bid2 organizations share this tax ID, including this one
Part of
Lexington Eye Assoc Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: fern.janelle.lea@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1699228445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1620",
            "fax_number": "781-863-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1620",
            "fax_number": "781-863-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON EYE ASSOCIATES-BID",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEXINGTON EYE ASSOCIATES, INC",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "MULLON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-862-1620",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S100198299",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.