Kalah Barrett
Individual provider Active NPI Optometrist · Reading, MA
NPI 1770073173 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1770073173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 5332 (MA)
- Practice address
- 70 Haven St
Reading, MA 01867-2929 - Phone
- (781) 942-0044
- NPI assigned
- May 11, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181102002170 | TN | Practitioner - Optometry | 0042563322 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3479 | TN | MD | Mental Health Counselor |
| 5332 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2020 Florida, PA | Optometrist | Current |
Accepting new patients |
| Mark a. Bowers | Optometrist | Past |
Accepting new patients |
Locations
29 Garden St
Everett, MA 02149
Phone (617) 356-8117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3479 | TN | |
| Optometrist | 152W00000X | 5332 | MA | Yes |
Addresses
Primary practice location
70 Haven St
Reading, MA 01867-2929
Mailing address
70 Haven St
Reading, MA 01867-2929
Phone (781) 942-0044
Other practice location 1
33 Arch St Fl 17
Boston, MA 02110-1424
Phone (617) 356-8117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q037962 | Medicaid | TN |
Other providers in Reading, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.