Individual provider Active NPI

Peter H Bridger, O.D.

  • Optometrist
  • Danvers, MA
National Provider Identifier
1962504464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2872 Issued in MA
Practice address
37 Maple St
Danvers, MA 01923-2839
Phone
(978) 774-1118
Fax
(978) 762-4934
NPI assigned
Sep 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 2872 MA Primary

Addresses

Primary practice location

37 Maple St
Danvers, MA 01923-2839

Mailing address

10 Red Coach Rd
South Hamilton, MA 01982-2020
Phone (978) 468-4768

Other identifiers 1

IdentifierTypeStateIssuer
0354554MedicaidMA

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
I20051208000372 MA Practitioner - Optometry 9931120755 Practice locations: Beverly, MA; Danvers, MA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Enon St
Beverly, MA 01915-1168
Phone (978) 922-7120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2872MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Star Dental Group Past Accepting new patients
Leslie K Carey OD LLC Optometrist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962504464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RED COACH RD",
            "city": "SOUTH HAMILTON",
            "state": "MA",
            "postal_code": "019822020",
            "telephone_number": "978-468-4768",
            "fax_number": "978-762-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 MAPLE ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232839",
            "telephone_number": "978-774-1118",
            "fax_number": "978-762-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGER",
        "first_name": "PETER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0354554",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.