Enian Kallamata, OD, MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

5418 Issued in MA

Practice address

63 Station LNDG
Medford, MA 02155-5192

Phone

(781) 393-5367

Fax

(617) 453-5757

NPI assigned

Aug 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

New England College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Eye Care at Davis IncGroup PAC ID 0143545160, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• All Eye Care at Davis, Inc

  • Optometrist
  • Medford, MA
  • NPI 1700216090
  Medicare reassignment Care Compare group NPD
• Eyespot, LLC

  • Ophthalmology Physician
  • Chestnut Hill, MA
  • NPI 1740596915
  NPD (past)

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1700498672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BLUE JAY CIR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021261994",
            "telephone_number": "857-492-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 STATION LNDG",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555192",
            "telephone_number": "781-393-5367",
            "fax_number": "617-453-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLAMATA",
        "first_name": "ENIAN",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joyce, RN
• Einhae Jung, MA
• Patricia Jurkevich
• Zoe Kaier-Green, AUD
• Aparna S Kallakurchi, DMD
• Paul K. Kang, D.M.D.
• Serap Kantarci, LMHC
• Inna Kaplun, DPT
• Joan Karpinski, LICSW
• Jennifer Kasami, RN

• Optometrist in Medford, MA
• Providers in Medford, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.