Organization Active NPI

Associated Eye Physicians & Surgeons Inc

  • Ophthalmology Physician
  • Quincy, MA
National Provider Identifier
1730180274
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
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

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Gary E Borodic, MDNPI 1568456291
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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
9770224MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091123000112 MA Part B Supplier - Clinic/Group Practice 9335288836 Receives reassigned benefits from 2 practitioners
Practice locations: Quincy, MA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.