Individual provider Active NPI

Anh V Bui, OD

  • Pediatric Optometrist
  • Boston, MA
National Provider Identifier
1891363644
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
OPT5604 Issued in MA
Practice address
424 Beacon St
Boston, MA 02115-1129
Phone
(617) 587-5545
NPI assigned
Jun 16, 2021
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT5604 MA
Optometrist 152W00000X OPT.006985 OH
Pediatric Optometrist 152WP0200X OPT5604 MA Primary

Addresses

Primary practice location

424 Beacon St
Boston, MA 02115-1129

Mailing address

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other practice location 1

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

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
I20230830002958 MA Practitioner - Optometry 3476930454 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT5604MAMDOptometrist
OPT.006985OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Codman Square Health Center Inc CurrentSince Aug 4, 2023 Accepting new patients
New England Eye Institute Inc. Optometrist CurrentSince Jul 29, 2023 Accepting new patients
South Boston Community Health Center CurrentSince Oct 15, 2023 Accepting new patients

Locations

930 Commonwealth Ave
Boston, MA 02215
Phone (617) 262-2020

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: abui137094@direct.bmc.masshiway.net
  • Direct secure messaging: abui298044@direct.ochin.org

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1891363644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 BEACON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021151129",
            "telephone_number": "617-587-5545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Washington St",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021243510",
            "country_code": "US",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUI",
        "first_name": "ANH",
        "middle_name": "V",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5604",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006985",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "OPT5604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.