Active NPI
Associated Eye Physicians & Surgeons Inc
- Ophthalmology Physician
- Quincy, MA
National Provider Identifier
1730180274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- ASSOCIATED EYE PHYSICIANS & SURGEONS INC
- Practice address
- 1261 Furnace Brook Pkwy
Suite 15
Quincy, MA 02169-4721 - Phone
- (617) 770-0011
- Fax
- (617) 770-0030
- NPI assigned
- Aug 9, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary E Borodic, MD
- Title
- President
- Phone
- (617) 770-0011
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MA | Primary |
Addresses
Primary practice location
1261 Furnace Brook Pkwy
Suite 15
Quincy, MA 02169-4721
Mailing address
340 Main St
Suite 670
Worcester, MA 01608-1604
Phone (508) 754-3566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9770224 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091123000112 | MA | Part B Supplier - Clinic/Group Practice | 9335288836 |
Receives reassigned benefits from 2 practitioners Practice locations: Quincy, MA |
National Provider Directory
National Provider DirectoryLocations
1261 Furnace Brook Pkwy
Ste 15
Quincy, MA 02169
Phone (617) 248-9482
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anesthesiology Physician
- Brighton, MA
- NPI 1023099934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1312329600000",
"number": "1730180274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 MAIN ST",
"address_2": "SUITE 670",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081604",
"telephone_number": "508-754-3566",
"fax_number": "508-798-8012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1261 FURNACE BROOK PKWY",
"address_2": "SUITE 15",
"city": "QUINCY",
"state": "MA",
"postal_code": "021694721",
"telephone_number": "617-770-0011",
"fax_number": "617-770-0030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASSOCIATED EYE PHYSICIANS & SURGEONS INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-09",
"last_updated": "2011-08-03",
"status": "A",
"authorized_official_last_name": "BORODIC",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "617-770-0011",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9770224",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.