Individual provider Active NPI

Monisha Rajinikanth, OD

  • Optometrist
  • Portsmouth, NH
National Provider Identifier
1710407325
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0945 Issued in NH
Practice address
155 Borthwick Ave # 200
Portsmouth, NH 03801-7156
Phone
(603) 436-1773
NPI assigned
Jun 24, 2017
Last updated
May 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 0945 NH Primary

Addresses

Primary practice location

155 Borthwick Ave # 200
Portsmouth, NH 03801-7156

Mailing address

155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184
Phone (603) 436-1773

Other identifiers 1

IdentifierTypeStateIssuer
3110591MedicaidNH

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
I20210727003793 MA Practitioner - Optometry 5698048270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Institute of TechnologyGroup PAC ID 5597658666, 55 clinicians

Practice addresses (Care Compare)

25 Carleton St
Cambridge, MA 02142-1323
Phone (617) 258-6896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince Aug 16, 2021 Accepting new patients
Edward a Ryan, MD, PC Past Accepting new patients

Locations

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1710407325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE STE 200E",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014184",
            "telephone_number": "603-436-1773",
            "fax_number": "603-427-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE # 200",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017156",
            "telephone_number": "603-436-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJINIKANTH",
        "first_name": "MONISHA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-24",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3110591",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.