NPIMap

Organization Active NPI

Dr. Elizabeth Prokos Berry

Doing business as Sturbridge Eye Care

  • Optometrist
  • Sturbridge, MA
National Provider Identifier
1750776589
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA3274 Issued in MA
Legal business name
DR. ELIZABETH PROKOS BERRY
Doing business as
Sturbridge Eye Care
Practice address
135 Main St
Suite 5
Sturbridge, MA 01566-1569
Phone
(508) 347-7309
Fax
(508) 347-7451
NPI assigned
Mar 30, 2015
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Elizabeth Prokos Berry, O.D.NPI 1356326532
Title
Optometrist/ Owner
Phone
(508) 347-7309

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
Optometrist 152W00000X MA3274 MA Primary

Addresses

Primary practice location

135 Main St
Suite 5
Sturbridge, MA 01566-1569

Mailing address

135 Main St
Suite 5
Sturbridge, MA 01566-1569
Phone (508) 347-7309

Other identifiers 1

IdentifierTypeStateIssuer
0371050MedicaidMA

Other names 1

  • Sturbridge Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

135 Main St
Ste 5
Sturbridge, MA 01566
Phone (508) 347-7309

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1750776589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MAIN ST",
            "address_2": "SUITE 5",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015661569",
            "telephone_number": "508-347-7309",
            "fax_number": "508-347-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 MAIN ST",
            "address_2": "SUITE 5",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "015661569",
            "telephone_number": "508-347-7309",
            "fax_number": "508-347-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ELIZABETH PROKOS BERRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "PROKOS",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "508-347-7309",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA3274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0371050",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sturbridge Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sturbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.