NPIMap

Organization Active NPI

Eye Associates PC

  • Ophthalmologic Surgery Clinic/Center
  • Burlington, MA
National Provider Identifier
1790789741
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
Legal business name
EYE ASSOCIATES PC
Practice address
172 Cambridge St
Burlington, MA 01803-2984
Phone
(781) 272-4944
Fax
(781) 272-8756
NPI assigned
Jun 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Authorized official

Name
David S Gendelman, MDNPI 1730186818
Title
President
Phone
(781) 272-4944

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
Ophthalmologic Surgery Clinic/Center 261QS0132X Primary

Addresses

Primary practice location

172 Cambridge St
Burlington, MA 01803-2984

Mailing address

172 Cambridge St
Burlington, MA 01803-2984
Phone (781) 272-4944

Other identifiers 1

IdentifierTypeStateIssuer
9762876MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051206000274 MA Part B Supplier - Clinic/Group Practice 6002836079 Receives reassigned benefits from 17 practitioners
Practice locations: Woburn, MA; Wilmington, MA; Tewksbury, MA; Arlington, MA; Burlington, MA
O20100930091135 MA DME Supplier - Physician - Ophthalmology 6002836079 Practice locations: Burlington, MA

National Provider Directory

National Provider Directory
Tax ID family
Eye Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

172 Cambridge St
Ste 301
Burlington, MA 01803

1565 Main St
Ste 3
Tewksbury, MA 01876
Phone (781) 272-4944

1565 Main St
Bldg B
Tewksbury, MA 01876

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1790789741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018032984",
            "telephone_number": "781-272-4944",
            "fax_number": "781-272-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018032984",
            "telephone_number": "781-272-4944",
            "fax_number": "781-272-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "GENDELMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-272-4944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9762876",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.