NPIMap

Organization Active NPI

Ophthalmic Consultants of Boston

  • Ophthalmology Physician
  • Cambridge, MA
National Provider Identifier
1922337393
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
OPHTHALMIC CONSULTANTS OF BOSTON
Practice address
625 Mount Auburn St
Suite 100
Cambridge, MA 02138-4555
Phone
(617) 492-1174
Fax
(617) 492-6807
NPI assigned
Dec 15, 2009
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Suzanne McDermott
Title
Authorized Official
Phone
(617) 314-2672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

625 Mount Auburn St
Suite 100
Cambridge, MA 02138-4555

Mailing address

50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone (617) 367-4800

Other identifiers 1

IdentifierTypeStateIssuer
110067330IMedicaidMA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2102972Ophthalmic Consultants of Boston625 Mount Auburn St, Cambridge, MA 02138Certificate of waiverOct 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ophthalmic Consult of B11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1922337393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST",
            "address_2": "SUITE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-367-4800",
            "fax_number": "617-589-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MOUNT AUBURN ST",
            "address_2": "SUITE 100",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384555",
            "telephone_number": "617-492-1174",
            "fax_number": "617-492-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC CONSULTANTS OF BOSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "617-314-2672"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110067330I",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.