Organization Active NPI

Retina Specialists of Boston and Wellesley LLC

  • Retina Specialist (Ophthalmology) Physician
  • Wellesley Hills, MA
National Provider Identifier
1790574739
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
RETINA SPECIALISTS OF BOSTON AND WELLESLEY LLC
Practice address
1 Washington St Ste 300
Wellesley Hills, MA 02481-1706
Phone
(617) 256-7684
NPI assigned
May 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Caroline BaumalNPI 1891759106
Title
Owner
Phone
(617) 256-7684

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
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

1 Washington St Ste 300
Wellesley Hills, MA 02481-1706

Mailing address

1 Washington St Ste 300
Wellesley Hills, MA 02481-1706
Phone (617) 256-7684

Other practice location 1

326 Highland St
West Newton, MA 02465-2702
Phone (617) 256-7684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251111002110 MA Part B Supplier - Clinic/Group Practice 6204327950 Receives reassigned benefits from 1 practitioner
Practice locations: Wellesley Hills, MA

National Provider Directory

National Provider Directory

Locations

1 Washington St
Ste 300
Wellesley Hills, MA 02481
Phone (617) 256-7684

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1790574739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 300",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024811706",
            "telephone_number": "617-256-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 300",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024811706",
            "telephone_number": "617-256-7684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 Highland St",
            "address_purpose": "LOCATION",
            "city": "West Newton",
            "state": "MA",
            "postal_code": "024652702",
            "country_code": "US",
            "telephone_number": "617-256-7684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA SPECIALISTS OF BOSTON AND WELLESLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "BAUMAL",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-256-7684"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.