Individual provider Active NPI

Jennifer K. Hsiao-Fang-Yen, OD

  • Optometrist
  • Providence, RI
National Provider Identifier
1710454467
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTG00709 Issued in RI
Practice address
335R Prairie Ave
Providence, RI 02905-2426
Phone
(401) 444-0570
Fax
(401) 444-0427
NPI assigned
Oct 31, 2018
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5327 MA
Optometrist 152W00000X ODTG00709 RI Primary

Addresses

Primary practice location

335R Prairie Ave
Providence, RI 02905-2426

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other names 1

  • Jennifer Kim Hsiao Other name

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
I20190408000294 MA Practitioner - Optometry 8820339542 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Somerville Inc. Optometrist CurrentSince Mar 10, 2019 Accepting new patients
David M Luria OD PC Optometrist CurrentSince Apr 6, 2020 Accepting new patients
Aeg Massachusetts Professional PC Optometrist CurrentSince Mar 21, 2025 Accepting new patients
Harvard Street Neighborhood Health Center Inc Past Accepting new patients

Locations

12 Eliot St
Cambridge, MA 02138
Phone (617) 354-3303

174 Broadway
Somerville, MA 02145
Phone (617) 666-1800

Interoperability endpoints

  • Direct secure messaging: jennifer.hsiao.1@8526.direct.athenahealth.com

Organizations & group practices 4

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1710454467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335R PRAIRIE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052426",
            "telephone_number": "401-444-0570",
            "fax_number": "401-444-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSIAO-FANG-YEN",
        "first_name": "JENNIFER",
        "middle_name": "K.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5327",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HSIAO",
            "middle_name": "KIM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.