Individual provider Active NPI

Carolyn Te, OD

  • Optometrist
  • Brockton, MA
National Provider Identifier
1831761824
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5560 Issued in MA
Practice address
21 Torrey St
Brockton, MA 02301-4849
Phone
(508) 587-8344
NPI assigned
Jul 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5560 MA Primary

Addresses

Primary practice location

21 Torrey St
Brockton, MA 02301-4849

Mailing address

25 Green Hollow Rd
Danielson, CT 06239-3509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210810002198 CT Practitioner - Optometry 0941604102 Reassigns benefits to 1 organization
I20230607003102 MA Practitioner - Optometry 0941604102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5560MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
City Eye, LLC Optometrist CurrentSince Apr 30, 2023 Accepting new patients
Luxottica of America Inc PastSince Apr 30, 2023 Accepting new patients

Locations

850 Washington St
Middletown, CT 06457
Phone (860) 347-4664

35 Talcottville Rd
Vernon Rockville, CT 06066
Phone (860) 870-6337

249 Hartford Ave
Bellingham, MA 02019

249 Hartford Ave
Spc A170
Bellingham, MA 02019
Phone (774) 295-2018

450 Washington St
Boston, MA 02111
Phone (617) 988-0607

21 Torrey St
Brockton, MA 02301
Phone (508) 580-8901

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1831761824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014849",
            "telephone_number": "508-587-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TE",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.