Individual provider Active NPI

Mark A. Traveis, O.D.

  • Optometrist
  • Burlington, MA
National Provider Identifier
1871566794
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3790 Issued in MA
Practice address
385 Cambridge St
Burlington, MA 01803-1944
Phone
(781) 272-9365
Fax
(781) 272-0366
NPI assigned
Feb 10, 2006
Last updated
Jul 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3790 MA Primary

Addresses

Primary practice location

385 Cambridge St
Burlington, MA 01803-1944

Mailing address

385 Cambridge St
Burlington, MA 01803-1944
Phone (781) 272-9365

Other identifiers 1

IdentifierTypeStateIssuer
0369748MedicaidMA

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
I20081010000018 MA Practitioner - Optometry 9638247174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgetown Eye Associates IncGroup PAC ID 9436284841, 2 clinicians

Practice addresses (Care Compare)

2 Central St
Suite 2
Georgetown, MA 01833-2070
Phone (978) 352-5966

385 Cambridge St
Burlington, MA 01803-1944
Phone (781) 272-9365

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3790MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington Vision Associates, Inc. Optometrist Current Accepting new patients
Georgetown Eye Associates Inc Optometrist CurrentSince Mar 26, 2009 Accepting new patients
Burlington Vision Associates Inc Optometrist CurrentSince Dec 26, 2001 Accepting new patients

Locations

385 Cambridge St
Burlington, MA 01803
Phone (781) 272-9365

1 E Main St
Georgetown, MA 01833
Phone (978) 352-6135

2 Central St
Ste 2
Georgetown, MA 01833
Phone (978) 352-5966

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1871566794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018031944",
            "telephone_number": "781-272-9365",
            "fax_number": "781-272-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018031944",
            "telephone_number": "781-272-9365",
            "fax_number": "781-272-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVEIS",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0369748",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.