Organization Active NPI

Pediatric Ophthalmology of Western Massachusetts, LLC

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Agawam, MA
National Provider Identifier
1851966758
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
PEDIATRIC OPHTHALMOLOGY OF WESTERN MASSACHUSETTS, LLC
Practice address
2 S Bridge Dr Ste 2D
Agawam, MA 01001-2091
Phone
(413) 368-2017
Fax
(413) 774-2120
NPI assigned
May 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Dr. Michael Scott Abrams, MDNPI 1750325635
Title
Managing Member
Phone
(413) 368-2017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0110X Primary

Addresses

Primary practice location

2 S Bridge Dr Ste 2D
Agawam, MA 01001-2091

Mailing address

2 S Bridge Dr Ste 2D
Agawam, MA 01001-2091
Phone (413) 368-2017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607002235 MA Part B Supplier - Clinic/Group Practice 7012317456 Receives reassigned benefits from 1 practitioner
Practice locations: Agawam, MA

National Provider Directory

National Provider Directory

Locations

2 S Bridge Dr
Ste 2D
Agawam, MA 01001
Phone (413) 314-2342

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1851966758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S BRIDGE DR STE 2D",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012091",
            "telephone_number": "413-368-2017",
            "fax_number": "413-774-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S BRIDGE DR STE 2D",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012091",
            "telephone_number": "413-368-2017",
            "fax_number": "413-774-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC OPHTHALMOLOGY OF WESTERN MASSACHUSETTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "ABRAMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "413-368-2017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.