Individual provider Active NPI

Jessica Chung, OD

  • Optometrist
  • Dedham, MA
National Provider Identifier
1740972876
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5624 Issued in MA
Practice address
1 Lyons St
Dedham, MA 02026-5599
Phone
(617) 657-6455
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5624 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Lyons St
Dedham, MA 02026-5599

Mailing address

1 Lyons St
Dedham, MA 02026-5599
Phone (617) 657-6455

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
I20240614003166 MA Practitioner - Optometry 0345783684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5624MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Optometrist CurrentSince Aug 1, 2024 Accepting new patients
Atrius Health, Inc. Optometrist Current Accepting new patients
Atrius Health, Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

1 Lyons St
Dedham, MA 02026
Phone (781) 278-5511

Interoperability endpoints

  • Direct secure messaging: jchungod383287@direct.atrius.masshiway.net

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1740972876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "617-657-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "617-657-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5624",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.