Organization Active NPI

Dream Vision LLC

  • Optometrist
  • Dorchester, MA
National Provider Identifier
1902216146
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DREAM VISION LLC
Practice address
1461 Dorchester Ave
Dorchester, MA 02122-1338
Phone
(617) 265-0728
Fax
(617) 265-0931
NPI assigned
Apr 28, 2014
Last updated
Jun 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Authorized official

Name
Ha Tien Le, OD/OWNER
Title
OD/Owner
Phone
(617) 265-0728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1461 Dorchester Ave
Dorchester, MA 02122-1338

Mailing address

1461 Dorchester Ave
Dorchester, MA 02122-1338
Phone (617) 265-0728

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141002001886 MA Part B Supplier - Clinic/Group Practice 0143440750 Receives reassigned benefits from 3 practitioners
Practice locations: Dorchester, MA

National Provider Directory

National Provider Directory

Locations

1350 Dorchester Ave
Dorchester, MA 02122
Phone (617) 265-0728

1461 Dorchester Ave
Dorchester, MA 02122
Phone (617) 265-0728

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1902216146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221338",
            "telephone_number": "617-265-0728",
            "fax_number": "617-265-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021221338",
            "telephone_number": "617-265-0728",
            "fax_number": "617-265-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "HA",
        "authorized_official_middle_name": "TIEN",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "617-265-0728",
        "authorized_official_credential": "OD/OWNER"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.