NPIMap

Organization Active NPI

Watertown Eye Group, Inc.

  • Optometrist
  • Watertown, MA
National Provider Identifier
1841674751
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Dr. Alex Russakovsky, O.D.
Title
President
Phone
(617) 285-4575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4635 MA Primary

Addresses

Primary practice location

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

Mailing address

22 McGrath Hwy # 4
C/O Pearle Vision
Somerville, MA 02143-4508
Phone (617) 623-7522

National Provider Directory

National Provider Directory

NPI Registry JSON

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": []
}

Other providers in Watertown, MA

Sources for this page

  • 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.