NPIMap

Organization Active NPI

Burlington Vision Associates Inc

  • Optometrist
  • Burlington, MA
National Provider Identifier
1962414714
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA3790 Issued in MA
Legal business name
BURLINGTON VISION ASSOCIATES INC
Practice address
385 Cambridge St
Burlington, MA 01803
Phone
(781) 272-9365
Fax
(781) 272-0366
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Authorized official

Name
Dr. Mark A Traveis, ODNPI 1871566794
Title
Owner
Phone
(508) 837-3790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X MA3790 MA Primary

Addresses

Primary practice location

385 Cambridge St
Burlington, MA 01803

Mailing address

385 Cambridge St
Burlington, MA 01803
Phone (508) 837-3790

Other identifiers 12

IdentifierTypeStateIssuer
0369748MedicaidMA
03790OtherVISION BENEFITS OF AMER
66285OtherFALLON
0021531OtherNEIGHBORHOOD HEALTH
152293OtherFIRST SENIORITY
152293OtherHPHC
40860OtherDAVIS
1784321OtherUNITED HEALTHCARE
W20254OtherMABCBS
760854OtherMATUFTS
94005342OtherPRIVATE HEALTHCARE SYSTEM
MA3790OtherEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081009000666 MA Part B Supplier - Clinic/Group Practice 1456429075 Receives reassigned benefits from 2 practitioners
Practice locations: Burlington, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1962414714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01803",
            "telephone_number": "508-837-3790",
            "fax_number": "781-272-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 CAMBRIDGE ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01803",
            "telephone_number": "781-272-9365",
            "fax_number": "781-272-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON VISION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "TRAVEIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-837-3790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA3790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0369748",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS OF AMER",
            "identifier": "03790",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "66285",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0021531",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "152293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "152293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "40860",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1784321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W20254",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "760854",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "94005342",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "MA3790",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.