Individual provider Active NPI

Daniel Arthur Bastian, OD

  • Optometrist
  • Brockton, MA
National Provider Identifier
1770848384
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4921 Issued in MA
Practice address
940 Belmont St
Brockton, MA 02301-5596
Phone
(508) 583-4500
NPI assigned
Jul 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002619 PA
Optometrist 152W00000X 4921 MA Primary

Addresses

Primary practice location

940 Belmont St
Brockton, MA 02301-5596

Mailing address

12 Revere PL
Medford, MA 02155-3903
Phone (508) 517-0865

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
I20130131000371 MA Practitioner - Optometry 4587818430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

20 Central Ave
Lynn, MA 01901-1314

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4921MAMDMental Health Counselor
OEG002619PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Redstone Eye Associates, LLC Optometrist CurrentSince Jun 6, 2025 Accepting new patients
Bastian Eyecare Professionals Optometrist Past Accepting new patients
Aeg Massachusetts Professional PC Optometrist PastSince Dec 27, 2022 Accepting new patients
All Eye Care at Davis, Inc Optometrist PastSince Nov 24, 2012 Accepting new patients

Locations

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

75 Main St
Stoneham, MA 02180
Phone (781) 438-2505

Interoperability endpoints

  • Direct secure messaging: dbastian150379@direct.ochin.org

Organizations & group practices 5

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": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1770848384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 REVERE PL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553903",
            "telephone_number": "508-517-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "508-583-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "DANIEL",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002619",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.