NPIMap

Organization Active NPI

Optometric Providers Inc

  • Optometrist
  • Boston, MA
National Provider Identifier
1790734010
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTOMETRIC PROVIDERS INC
Practice address
100 State St
Boston, MA 02109
Phone
(617) 742-2076
Fax
(617) 557-9276
NPI assigned
May 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Alerino M Iacobbo, OD
Title
President
Phone
(314) 446-3145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

100 State St
Boston, MA 02109

Mailing address

2921 Erie Blvd E
Optometric Providers Inc
Syracuse, NY 13224
Phone (315) 446-3145

Other identifiers 1

IdentifierTypeStateIssuer
9781048MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Optometric Providers Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790734010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD E",
            "address_2": "OPTOMETRIC PROVIDERS INC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13224",
            "telephone_number": "315-446-3145",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STATE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109",
            "telephone_number": "617-742-2076",
            "fax_number": "617-557-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC PROVIDERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IACOBBO",
        "authorized_official_first_name": "ALERINO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-446-3145",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9781048",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.