NPIMap

Organization Active NPI

Vitreo-Retinal Associates of Worcester PC

  • Ophthalmology Physician
  • Worcester, MA
National Provider Identifier
1912930330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
VITREO-RETINAL ASSOCIATES OF WORCESTER PC
Practice address
67 Belmont St
Suite 302
Worcester, MA 01605-2657
Phone
(508) 752-1155
Fax
(508) 752-4862
NPI assigned
Jul 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sandy M. Rheaume
Title
Office Manager
Phone
(508) 752-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

67 Belmont St
Suite 302
Worcester, MA 01605-2657

Mailing address

67 Belmont St
Suite 302
Worcester, MA 01605-2657
Phone (508) 752-1155

Other identifiers 1

IdentifierTypeStateIssuer
9723838MedicaidMA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912930330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 BELMONT ST",
            "address_2": "SUITE 302",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052657",
            "telephone_number": "508-752-1155",
            "fax_number": "508-752-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BELMONT ST",
            "address_2": "SUITE 302",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052657",
            "telephone_number": "508-752-1155",
            "fax_number": "508-752-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITREO-RETINAL ASSOCIATES OF WORCESTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RHEAUME",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "508-752-1155",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9723838",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.