Individual provider Active NPI

Sandra Miriam Yelen, O.D.

  • Optometrist
  • Leominster, MA
National Provider Identifier
1740260975
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3744 Issued in MA
Practice address
875 Merriam Ave 127
Leominster, MA 01453-1236
Phone
(978) 537-0202
Fax
(978) 537-0303
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3744 MA Primary

Addresses

Primary practice location

875 Merriam Ave 127
Leominster, MA 01453-1236

Mailing address

875 Merriam Ave 127
Leominster, MA 01453-1236
Phone (978) 537-0202

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
I20041210000348 MA Practitioner - Optometry 5890752943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

875 Merriam Ave
Suite 127
Leominster, MA 01453-1236
Phone (978) 537-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3744MAMDChiropractor

Organizations & group practices 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1740260975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MERRIAM AVE 127",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531236",
            "telephone_number": "978-537-0202",
            "fax_number": "978-537-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MERRIAM AVE 127",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531236",
            "telephone_number": "978-537-0202",
            "fax_number": "978-537-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELEN",
        "first_name": "SANDRA",
        "middle_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.