Individual provider Active NPI

Moojan Rouhi, OD

  • Optometrist
  • Carlisle, MA
National Provider Identifier
1912986134
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3466 Issued in MA
Practice address
65 Hutchins Rd
Carlisle, MA 01741-1027
Phone
(978) 371-8026
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 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 3466 MA Primary

Addresses

Primary practice location

65 Hutchins Rd
Carlisle, MA 01741-1027

Mailing address

65 Hutchins Rd
Carlisle, MA 01741-1027
Phone (978) 371-8026

Other identifiers 2

IdentifierTypeStateIssuer
0371980MedicaidMA
W15831OtherMABLUE CROSS BLUE SHIELD

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
I20090402000191 MA Practitioner - Optometry 1254488562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Lexington Eye Associates, IncGroup PAC ID 5698748986, 33 clinicians
Lexington Eye Associates - BidGroup PAC ID 8820315682, 33 clinicians

Practice addresses (Care Compare)

21 Worthen Rd
Lexington, MA 02421-4835
Phone (781) 862-1620

300 Baker Ave
Suite 210
Concord, MA 01742-2131
Phone (978) 369-1310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3466MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Eye Associates, Inc CurrentSince Feb 1, 2013 Accepting new patients
Emerson Hospital Current Accepting new patients
Lexington Eye Associates - Bid CurrentSince Jan 14, 2015 Accepting new patients
Lexington Eye Associates, Inc. CurrentSince Feb 1, 2013 Accepting new patients

Locations

21 Worthen Rd
Lexington, MA 02421
Phone (617) 862-1620

160 Littleton Rd
Ste 9
Westford, MA 01886
Phone (781) 876-2020

Interoperability endpoints

  • Direct secure messaging: rouhi.moojan.epho@direct.partners.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1912986134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HUTCHINS RD",
            "city": "CARLISLE",
            "state": "MA",
            "postal_code": "017411027",
            "telephone_number": "978-371-8026",
            "fax_number": "978-686-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HUTCHINS RD",
            "city": "CARLISLE",
            "state": "MA",
            "postal_code": "017411027",
            "telephone_number": "978-371-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUHI",
        "first_name": "MOOJAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0371980",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W15831",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, MA

Sources for this page

Verify at the official NPI Registry.