Individual provider Active NPI

Susan Marianne O'Shea, O.D.

  • Optometrist
  • Boston, MA
National Provider Identifier
1821109703
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4515 Issued in MA
Practice address
1341 Boylston St
Boston, MA 02215-3909
Phone
(508) 661-9532
NPI assigned
Aug 31, 2006
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4515 MA Primary
Pediatric Optometrist 152WP0200X 4515 MA
Vision Therapy Optometrist 152WV0400X 4515 MA

Addresses

Primary practice location

1341 Boylston St
Boston, MA 02215-3909

Mailing address

1341 Boylston St
Boston, MA 02215-3909
Phone (508) 661-9532

Other identifiers 1

IdentifierTypeStateIssuer
110073128MedicaidMA

Other names 1

  • Dr. Susan Marianne Foley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908001124 MA Practitioner - Optometry 8921030040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1341 Boylston St
Boston, MA 02215-3909
Phone (508) 661-9532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4515MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ez Eyecare Inc Optometrist CurrentSince Mar 7, 2009 Accepting new patients
Kenmore Optical CurrentSince Jan 24, 2021 Accepting new patients

Locations

1341 Boylston St
Boston, MA 02215
Phone (508) 661-9532

1018 Beacon St
Ste 100
Brookline, MA 02446
Phone (617) 536-7870

26 Whittier St
Framingham, MA 01701
Phone (508) 380-8966

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1821109703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153909",
            "telephone_number": "508-661-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153909",
            "telephone_number": "508-661-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "SUSAN",
        "middle_name": "MARIANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4515",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "4515",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MA",
            "license": "4515",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110073128",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "FOLEY",
            "middle_name": "MARIANNE",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.