Individual provider Active NPI

Elizabeth J.S. Redman, OD

  • Optometrist
  • Pembroke, MA
National Provider Identifier
1750332839
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4541 Issued in MA
Practice address
75 Washington St Ste 3
Mass Optometric Associates, P.C.
Pembroke, MA 02359-1887
Phone
(781) 826-5117
Fax
(781) 826-0954
NPI assigned
May 13, 2006
Last updated
Jan 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4541 MA Primary

Addresses

Primary practice location

75 Washington St Ste 3
Mass Optometric Associates, P.C.
Pembroke, MA 02359-1887

Mailing address

2921 Erie Blvd E
C/O Empire Vision Center, Inc
Syracuse, NY 13224-1430
Phone (315) 445-7465

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
I20051215000622 MA Practitioner - Optometry 7618998824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass Optometric Associates, PLLCGroup PAC ID 0648362442, 50 clinicians

Practice addresses (Care Compare)

75 Washington St
Suite 3
Pembroke, MA 02359-1887
Phone (781) 826-5117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4541MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, P.C. Optometrist Past Accepting new patients
Empire Vision Center, Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1750332839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD E",
            "address_2": "C/O EMPIRE VISION CENTER, INC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241430",
            "telephone_number": "315-445-7465",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST STE 3",
            "address_2": "MASS OPTOMETRIC ASSOCIATES, P.C.",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591887",
            "telephone_number": "781-826-5117",
            "fax_number": "781-826-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMAN",
        "first_name": "ELIZABETH",
        "middle_name": "J.S.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

Verify at the official NPI Registry.