Individual provider Active NPI

Taline Farra, O.D.

  • Optometrist
  • South Boston, MA
National Provider Identifier
1740363399
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4097 Issued in MA
Practice address
647 E Broadway
South Boston, MA 02127-1503
Phone
(617) 823-7534
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4097 MA Primary

Addresses

Primary practice location

647 E Broadway
South Boston, MA 02127-1503

Mailing address

647 E Broadway
Boston, MA 02127-1503
Phone (617) 269-9465

Other identifiers 5

IdentifierTypeStateIssuer
152831OtherMAHARVARD PILGRIM HEALTH
W16308OtherMABLUE CROSS BLUE SHEILD
0014570OtherMANEIGHBORHOOD HEALTH PLAN
22-00932OtherMAUNITED HEALTH CARE
38156OtherMAUNICARE

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
I20070109000161 MA Practitioner - Optometry 8729088190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wink Eyecare, Inc.Group PAC ID 6204069420, 2 clinicians

Practice addresses (Care Compare)

647 E Broadway
South Boston, MA 02127-1503
Phone (617) 823-7534

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4097MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wink Eyecare, Inc. Optometrist CurrentSince Apr 1, 2014 Accepting new patients
New England Eye Institute Inc. Optometrist Past Accepting new patients
Eye Associates of Somerville Inc. Optometrist PastSince Jun 2, 2014 Accepting new patients

Locations

647 E Broadway
South Boston, MA 02127
Phone (617) 269-9465

Organizations & group practices 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1740363399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 E BROADWAY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021271503",
            "telephone_number": "617-269-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 E BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271503",
            "telephone_number": "617-823-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRA",
        "first_name": "TALINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "152831",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "W16308",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014570",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "22-00932",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "38156",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

Verify at the official NPI Registry.