Individual provider Active NPI

Michael Kochanowski

  • Optometrist
  • Arlington, MA
National Provider Identifier
1780219394
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
PENDING Issued in MA
Practice address
1328 Massachusetts Ave
Arlington, MA 02476-4111
Phone
(781) 488-0094
NPI assigned
Mar 4, 2020
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X PENDING MA Primary

Addresses

Primary practice location

1328 Massachusetts Ave
Arlington, MA 02476-4111

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201019000795 MA Practitioner - Optometry 4284054941 Reassigns benefits to 2 organizations
I20220503000574 NH Practitioner - Optometry 4284054941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey L Morer OD PCGroup PAC ID 7719870807, shared by 11 NPIs, 50 clinicians

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

25 Ridgewood Rd
Bedford, NH 03110-6510
Phone (888) 964-6681

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGMAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist CurrentSince Mar 19, 2022 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist CurrentSince Mar 19, 2022 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince Dec 11, 2022 Accepting new patients
Jeffrey L. Morer, OD, PC Optometrist CurrentSince Oct 2, 2023 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Sep 8, 2020 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Sep 8, 2020 Accepting new patients
Myeyedr Optometry of New Hampshire, PLLC Optometrist PastSince Mar 16, 2021 Accepting new patients

Locations

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

1328 Massachusetts Ave
Arlington, MA 02476
Phone (617) 484-1414

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

25 Ridgewood Rd
Bedford, NH 03110
Phone (603) 222-0303

1 Brickyard Sq
Ste 11
Epping, NH 03042
Phone (603) 347-8377

2075 S Willow St
Manchester, NH 03103
Phone (603) 424-0404

9 Triangle Ln
Ste 204
Manchester, NH 03103
Phone (603) 644-6100

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 9

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1780219394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764111",
            "telephone_number": "781-488-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHANOWSKI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.