Individual provider Active NPI

Bruce L Rakusin, OD

  • Optometrist
  • Framingham, MA
National Provider Identifier
1952348534
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2509 Issued in MA
Practice address
255 Worcester Rd
Mass Optometric Associates, P.C. Sea N Surf Rte 9
Framingham, MA 01701-5308
Phone
(508) 879-3442
Fax
(508) 879-2251
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 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 2509 MA Primary

Addresses

Primary practice location

255 Worcester Rd
Mass Optometric Associates, P.C. Sea N Surf Rte 9
Framingham, MA 01701-5308

Mailing address

2921 Erie Blvd E
C/O Empire Vision Center, Inc
Syracuse, NY 13224-1430
Phone (315) 445-7465

Other identifiers 1

IdentifierTypeStateIssuer
0351261MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2509MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1952348534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD E",
            "address_2": "C/O EMPIRE VISION CENTER, INC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241430",
            "telephone_number": "315-445-7465",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WORCESTER RD",
            "address_2": "MASS OPTOMETRIC ASSOCIATES, P.C. SEA N SURF RTE 9",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017015308",
            "telephone_number": "508-879-3442",
            "fax_number": "508-879-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKUSIN",
        "first_name": "BRUCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0351261",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.