Individual provider Active NPI

Dzenana Idrizovic, OD

  • Optometrist
  • Somerville, MA
National Provider Identifier
1942216759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4544 Issued in MA
Practice address
65 Beacon St
Somerville, MA 02143-4324
Phone
(617) 665-1347
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4544 MA Primary

Addresses

Primary practice location

65 Beacon St
Somerville, MA 02143-4324

Mailing address

65 Beacon St
Somerville, MA 02143-4324
Phone (617) 665-1347

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
I20060818000037 MA Practitioner - Optometry 8628071388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Eye Care at Davis IncGroup PAC ID 0143545160, 3 clinicians

Practice addresses (Care Compare)

63 Station LNDG
Medford, MA 02155-5192
Phone (781) 393-5367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4544MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
All Eye Care at Davis, Inc Optometrist CurrentSince Nov 4, 2014 Accepting new patients
Eyecare Associates of Ma, P.C. Optometrist PastSince Nov 20, 2007 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

85 Middlesex Tpke
Ste 3040
Burlington, MA 01803
Phone (857) 600-0701

1 Boylston St
Ste 3D
Chestnut Hill, MA 02467
Phone (617) 232-3303

63 Station Lndg
Medford, MA 02155
Phone (781) 393-5367

63 Central St
#A
Wellesley, MA 02482
Phone (781) 235-7870

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942216759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BEACON ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434324",
            "telephone_number": "617-665-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BEACON ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434324",
            "telephone_number": "617-665-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIZOVIC",
        "first_name": "DZENANA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.