Individual provider Active NPI

Karin L Underkoffler, OD

  • Optometrist
  • Westborough, MA
National Provider Identifier
1699757666
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3378 Issued in MA
Practice address
900 Union St
Westborough, MA 01581-5408
Phone
(508) 871-1799
Fax
(508) 871-0779
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 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 3378 MA Primary

Addresses

Primary practice location

900 Union St
Westborough, MA 01581-5408

Mailing address

900 Union St
Westborough, MA 01581-5408
Phone (508) 856-9599

Other practice location 1

135 Goldstar Blvd
Worcester, MA 01606
Phone (508) 856-9599

Other identifiers 19

IdentifierTypeStateIssuer
042472266OtherTHREE RIVERS
35481174OtherCIGNA HEALTHSOURCE
60676OtherCHILDRENS MEDICAL SECURIT
0334979OtherMEDICAID WELFARE
110014770AMedicaidMA
W16361OtherBLUE SHIELD INDEMNITY
042472266OtherTRICARE CHAMPUS
042472266OtherPRIVATE HEALTHCARE SYSTEM
786731OtherMVP HEALTH CARE
B21204901OtherCIGNA HEALTH PLAN
61203OtherFALLON COMMUNITY HEALTH P
7023611OtherAETNA US HEALTHCARE
W16361OtherBLUE CARE ELECT
2213192OtherFIRST HEALTH
AA3021OtherHARVARD PILGRIM HEALTHCAR
W17198OtherMEDICARE B
410045265OtherRAILROAD MEDICARE
W16361OtherBLUE SHIELD HMO BLUE
6356724001OtherCIGNA PAL ID

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
I20060406000044 MA Practitioner - Optometry 6507875317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

900 Union St
Westborough, MA 01581-5408
Phone (508) 366-8836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Oct 6, 2004 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

900 Union St
Westborough, MA 01581
Phone (508) 871-0700

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Organizations & group practices 2

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1699757666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 UNION ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015815408",
            "telephone_number": "508-856-9599",
            "fax_number": "508-871-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 UNION ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015815408",
            "telephone_number": "508-871-1799",
            "fax_number": "508-871-0779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Goldstar Blvd",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01606",
            "country_code": "US",
            "telephone_number": "508-856-9599",
            "fax_number": "508-854-4997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNDERKOFFLER",
        "first_name": "KARIN",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "35481174",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "60676",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "0334979",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110014770A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "W16361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CHAMPUS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "786731",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "B21204901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "61203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7023611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "W16361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2213192",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA3021",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "W17198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410045265",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "W16361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL ID",
            "identifier": "6356724001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

Verify at the official NPI Registry.