NPIMap

Organization Active NPI

All Eye Care at Davis, Inc

  • Optometrist
  • Medford, MA
National Provider Identifier
1700216090
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4544 Issued in MA
Legal business name
ALL EYE CARE AT DAVIS, INC
Practice address
63 Station LNDG
Att. Dr Dzenana Idrizovic
Medford, MA 02155-5192
Phone
(603) 566-7463
NPI assigned
Nov 22, 2013
Last updated
Nov 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Authorized official

Name
Dr. Dzenana Idrizovic, O. D.NPI 1942216759
Title
Optometry Doctor
Phone
(603) 566-7463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4544 MA Primary

Addresses

Primary practice location

63 Station LNDG
Att. Dr Dzenana Idrizovic
Medford, MA 02155-5192

Mailing address

63 Station LNDG
Att. Dr Dzenana Idrizovic
Medford, MA 02155-5192
Phone (603) 566-7463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150216001667 MA Part B Supplier - Clinic/Group Practice 0143545160 Receives reassigned benefits from 5 practitioners
Practice locations: Burlington, MA; Cambridge, MA; Chestnut Hill, MA; Medford, MA; Wellesley, MA

National Provider Directory

National Provider Directory

Locations

75 Middlesex Tpke
Ste 3040
Burlington, MA 01803

85 Middlesex Tpke
Ste 3040
Burlington, MA 01803
Phone (857) 600-0701

63 Station Lndg
Medford, MA 02155
Phone (781) 393-5367

63 Central St
#A
Wellesley, MA 02482
Phone (781) 235-7870

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1700216090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 STATION LNDG",
            "address_2": "ATT. DR DZENANA IDRIZOVIC",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555192",
            "telephone_number": "603-566-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 STATION LNDG",
            "address_2": "ATT. DR DZENANA IDRIZOVIC",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555192",
            "telephone_number": "603-566-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL EYE CARE AT DAVIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "IDRIZOVIC",
        "authorized_official_first_name": "DZENANA",
        "authorized_official_title_or_position": "OPTOMETRY DOCTOR",
        "authorized_official_telephone_number": "603-566-7463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.