Individual provider Active NPI

Cora Mia Vitale, OD

  • Optometrist
  • Brookline, MA
National Provider Identifier
1700635828
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT5727 Issued in MA
Practice address
24 Webster PL
Brookline, MA 02445-7937
Phone
(617) 202-2020
Fax
(617) 734-3264
NPI assigned
May 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPT5727 MA Primary

Addresses

Primary practice location

24 Webster PL
Brookline, MA 02445-7937

Mailing address

220 Middlesex Ave
Medford, MA 02155-5000
Phone (978) 809-7675

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
I20250620001988 MA Practitioner - Optometry 6709398381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Laser Eye Institute PCGroup PAC ID 9739123381, 23 clinicians

Practice addresses (Care Compare)

24 Webster PL
Brookline, MA 02445-7937
Phone (617) 202-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT5727MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Laser Eye Institute, PC CurrentSince Jun 14, 2025 Accepting new patients
Boston Vision Network One-Lawrence LLC Past Accepting new patients

Locations

159 River Rd
#4
Andover, MA 01810

159 River Rd
Ste 4
Andover, MA 01810

24 Webster Pl
Brookline, MA 02445

172 Cambridge St
Burlington, MA 01803
Phone (701) 272-4944

172 Cambridge St
Ste 103
Burlington, MA 01803

25 Marston St
Ste 104
Lawrence, MA 01841
Phone (978) 685-5366

101 Main St
Ste 208
Medford, MA 02155
Phone (781) 395-5859

200 Fortune Blvd
Milford, MA 01757

204 Worcester St
Wellesley Hls, MA 02481
Phone (617) 566-0062

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: cora.vitale.p1@direct.bostoneyegroup.nextgenshare.com

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": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1700635828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MIDDLESEX AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555000",
            "telephone_number": "978-809-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "CORA",
        "middle_name": "MIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.