Individual provider Active NPI

Thomas Michael Anzaldi, OD

  • Optometrist
  • Lynn, MA
National Provider Identifier
1760548788
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2985OP Issued in MA
Practice address
427 Lynnway
Lynn, MA 01905-3028
Phone
(781) 599-2773
Fax
(781) 592-7215
NPI assigned
Dec 28, 2006
Last updated
Dec 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2985OP MA Primary

Addresses

Primary practice location

427 Lynnway
Lynn, MA 01905-3028

Mailing address

427 Lynnway
Lynn, MA 01905-3028
Phone (781) 599-2773

Other identifiers 1

IdentifierTypeStateIssuer
0345059MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2985OPMAMDOptometrist
2985MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Damyanova Eye Associates CurrentSince Jan 27, 2020 Accepting new patients

Locations

427 Lynnway
Lynn, MA 01905
Phone (781) 598-2773

Organizations & group practices 2

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1760548788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 LYNNWAY",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019053028",
            "telephone_number": "781-599-2773",
            "fax_number": "781-592-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 LYNNWAY",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019053028",
            "telephone_number": "781-599-2773",
            "fax_number": "781-592-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZALDI",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2985OP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345059",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.