Alan Richard Titelbaum, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2955 Issued in MA

Practice address

174 Broadway
Somerville, MA 02145-3129

Phone

(617) 666-1800

Fax

(617) 628-4930

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Associates of Somerville Inc.

  • Optometrist
  • Somerville, MA
  • NPI 1457491300
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1851351100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453129",
            "telephone_number": "617-666-1800",
            "fax_number": "617-628-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453129",
            "telephone_number": "617-666-1800",
            "fax_number": "617-628-4930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Humphrey St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Marblehead",
            "state": "MA",
            "postal_code": "019451665",
            "country_code": "US",
            "telephone_number": "781-639-9901",
            "fax_number": "781-808-4863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TITELBAUM",
        "first_name": "ALAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0343528",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Throne
• Amberly A Ticotsky, RN, BSN
• David Tierney, OD
• Emily Tingle
• Daisy Tirado
• Madeline Tkacs, B.S.
• Alexandra Todd, D.M.D
• Tino Tomasi
• Parra Tomkins, MD
• Kathleen Mary Tonne

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.