Active NPI
Jane Pentheny
- Optometrist
- Braintree, MA
National Provider Identifier
1801952569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3362
- Practice address
- 111 Grossman Dr
Braintree, MA 02184-4997 - Phone
- (781) 849-2295
- Fax
- (781) 849-2514
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 3362 | MA | Primary |
Addresses
Primary practice location
111 Grossman Dr
Braintree, MA 02184-4997
Mailing address
147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 421-2508
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0014540 | Other | MA | NHP |
| 9390295-002 | Other | MA | CIGNA |
| 003362 | Other | MA | TUFTS |
| 0393711 | Medicaid | MA | |
| E199 | Other | MA | HPHC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1801952569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT - 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-421-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 GROSSMAN DR",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021844997",
"telephone_number": "781-849-2295",
"fax_number": "781-849-2514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTHENY",
"first_name": "JANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "3362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "0014540",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9390295-002",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "003362",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0393711",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "E199",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.