Organization Active NPI

Lumen Vision Care

  • Optometrist
  • Canton, MA
National Provider Identifier
1821875279
Registry record updated Oct 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LUMEN VISION CARE
Practice address
95 Washington St Ste 466
Canton, MA 02021-4008
Phone
(781) 462-1719
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2023

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

Authorized official

Name
Jana WegrzynNPI 1629253877
Title
Optometrist
Phone
(508) 257-1516

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

95 Washington St Ste 466
Canton, MA 02021-4008

Mailing address

95 Washington St Ste 466
Canton, MA 02021-4008
Phone (508) 257-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231113003164 MA Part B Supplier - Clinic/Group Practice 1850748849 Receives reassigned benefits from 1 practitioner
Practice locations: Canton, MA

National Provider Directory

National Provider Directory

Locations

95 Washington St
Ste 466
Canton, MA 02021
Phone (508) 257-1516

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697328000000",
    "number": "1821875279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST STE 466",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214008",
            "telephone_number": "508-257-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST STE 466",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214008",
            "telephone_number": "781-462-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMEN VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A",
        "authorized_official_last_name": "WEGRZYN",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "508-257-1516"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2023; 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.