Individual provider Active NPI

Andrew Fonte

  • Optometrist
  • Quincy, MA
National Provider Identifier
1851975924
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5459 Issued in MA
Practice address
104 Quarry St Ste 3
Quincy, MA 02169-4175
Phone
(161) 748-1665
NPI assigned
May 5, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 5459 MA Primary

Addresses

Primary practice location

104 Quarry St Ste 3
Quincy, MA 02169-4175

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20210611002231 MA Practitioner - Optometry 9032519095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11 Harvard St
Suite 707
Brookline, MA 02445-7904
Phone (617) 739-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5459MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Jun 14, 2021 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Jun 14, 2021 Accepting new patients

Locations

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

231 Belmont St
Belmont, MA 02478
Phone (617) 484-1414

33 Broad St
Boston, MA 02109
Phone (617) 742-7200

11 Harvard St
Ste 707
Brookline, MA 02445
Phone (617) 739-4141

50 Mall Rd
Ste 114
Burlington, MA 01803
Phone (781) 229-2020

164 Sylvan St
Danvers, MA 01923
Phone (978) 744-4500

1191 Chestnut St
Newton Upper Falls, MA 02464
Phone (617) 243-3937

104 Quarry St
Ste 3
Quincy, MA 02169
Phone (617) 481-6650

27 Memorial Pkwy
Randolph, MA 02368
Phone (617) 986-7400

1 Washington St
Ste 101
Wellesley Hills, MA 02481
Phone (617) 332-1471

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1851975924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 QUARRY ST STE 3",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694175",
            "telephone_number": "161-748-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTE",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.