Individual provider Active NPI

Jami B Parsons Malloy, O.D.

  • Optometrist
  • Worcester, MA
National Provider Identifier
1720302672
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4909 Issued in MA
Practice address
10 Lincoln SQ
Worcester, MA 01608
Phone
(508) 373-5830
Fax
(508) 519-5512
NPI assigned
Mar 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 654 NV
Optometrist 152W00000X 13948 CA
Optometrist 152W00000X 4909 MA Primary

Addresses

Primary practice location

10 Lincoln SQ
Worcester, MA 01608

Mailing address

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

Other practice location 1

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5830

Other identifiers 1

IdentifierTypeStateIssuer
110093358AMedicaidMA

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
I20121017000778 MA Practitioner - Optometry 6204086879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
May accept Medicare assignment
Group practices
McPhs UniversityGroup PAC ID 2365682713, 19 clinicians

Practice addresses (Care Compare)

10 Lincoln SQ
Worcester, MA 01608-1135
Phone (508) 373-5830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4909MAMDOptometrist
654NVMDOptometrist
13948CAMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Feb 1, 2019 Accepting new patients
McPhs University Optometrist CurrentSince Nov 27, 2016 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Feb 1, 2019 Accepting new patients
Leominster Family Eyecare PLLC Optometrist PastSince Nov 27, 2016 Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

10 Lincoln Sq
Worcester, MA 01608
Phone (508) 373-5607

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

10 Lincoln Sq
Rm 112G
Worcester, MA 01608

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1720302672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081135",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LINCOLN SQ",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Lincoln Sq",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01608",
            "country_code": "US",
            "telephone_number": "508-373-5830",
            "fax_number": "508-519-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARSONS MALLOY",
        "first_name": "JAMI",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "654",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13948",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093358A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.