Individual provider Active NPI

Kim Ciampa-Maggio, O.D.

  • Optometrist
  • Melrose, MA
National Provider Identifier
1851448369
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA 3960 Issued in MA
Practice address
490 Main St
Melrose, MA 02176-3841
Phone
(781) 665-0897
Fax
(781) 665-8828
NPI assigned
Jan 5, 2007
Last updated
Aug 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MA 3960 MA Primary

Addresses

Primary practice location

490 Main St
Melrose, MA 02176-3841

Mailing address

33 Belmont PL
Melrose, MA 02176-1713
Phone (781) 665-5781

Other identifiers 3

IdentifierTypeStateIssuer
W16162OtherMABLUE CROSS BLUE SHIELD MA
0712833MedicaidMA
9376017OtherMACIGNA

Other names 1

  • Kim Ciampa Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070521000334 MA Practitioner - Optometry 8527165869 Reassigns benefits to 1 organization
Practice locations: Melrose, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

490 Main St
Melrose, MA 02176-3841
Phone (781) 665-0897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MA 3960MAMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1851448369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BELMONT PL",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021761713",
            "telephone_number": "781-665-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763841",
            "telephone_number": "781-665-0897",
            "fax_number": "781-665-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAMPA-MAGGIO",
        "first_name": "KIM",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA 3960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "W16162",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0712833",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9376017",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "CIAMPA",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.