Active NPI
Stephen B Adelstein, OD
- Optometrist
- Chelmsford, MA
National Provider Identifier
1790770980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3089
- Practice address
- 11 Summer St
Unit 1
Chelmsford, MA 01824-3064 - Phone
- (978) 256-5731
- Fax
- (978) 256-1553
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3089 | MA | Primary |
Addresses
Primary practice location
11 Summer St
Unit 1
Chelmsford, MA 01824-3064
Mailing address
PO Box 298
11 Summer St
Chelmsford, MA 01824-0298
Phone (978) 256-5731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0352705 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3089 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1790770980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 298",
"address_2": "11 SUMMER ST",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018240298",
"telephone_number": "978-256-5731",
"fax_number": "978-256-1553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 SUMMER ST",
"address_2": "UNIT 1",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018243064",
"telephone_number": "978-256-5731",
"fax_number": "978-256-1553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADELSTEIN",
"first_name": "STEPHEN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "3089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0352705",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chelmsford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.