Watertown Eye Group, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4635 Issued in MA

Legal business name

WATERTOWN EYE GROUP, INC.

Practice address

485 Arsenal St
C/O Pearle Vision
Watertown, MA 02472-5091

Phone

(617) 923-2022

Fax

(617) 923-2023

NPI assigned

Jul 10, 2015

Last updated

Jul 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alex Russakovsky, O.D.NPI 1366634792

Title

President

Phone

(617) 285-4575

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alex Russakovsky, O.D.

  • Optometrist
  • Somerville, MA
  • NPI 1366634792
  Authorized official Same address or phone

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1841674751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MCGRATH HWY # 4",
            "address_2": "C/O PEARLE VISION",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434508",
            "telephone_number": "617-623-7522",
            "fax_number": "617-623-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 ARSENAL ST",
            "address_2": "C/O PEARLE VISION",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024725091",
            "telephone_number": "617-923-2022",
            "fax_number": "617-923-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN EYE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "RUSSAKOVSKY",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-285-4575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Watertown Cosmetic and Pediatric Dentistry, P.C.
• Watertown Dental Associates PLLC
• Watertown Dental Center
• Watertown Dentistry
• Watertown Dermatology Associates, LLC
• Watertown Family Dental PC
• Watertown Health Center, LLC (Watertown Health Center)
• Watertown Rehabilitation and Nursing Center LLC
• Ellis Weaver, LMHC
• Kevin R Wehmhoefer, LICSW, ACSW

• Optometrist in Watertown, MA
• Providers in Watertown, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.