Organization Active NPI

Lawrence D. Siegel, O.D., LLC

  • Optometrist
  • Newton, MA
National Provider Identifier
1962546929
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3545 Issued in MA
Legal business name
LAWRENCE D. SIEGEL, O.D., LLC
Practice address
300 Needham St
# 4
Newton, MA 02464-1532
Phone
(617) 232-0220
Fax
(617) 734-9738
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
Lawrence D Siegel, O.D.
Title
Director
Phone
(617) 232-0220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3545 MA Primary

Addresses

Primary practice location

300 Needham St
# 4
Newton, MA 02464-1532

Mailing address

300 Needham St
# 4
Newton, MA 02464-1532
Phone (617) 232-0220

Other identifiers 1

IdentifierTypeStateIssuer
110083510AMedicaidMA

National Provider Directory

National Provider Directory

Locations

300 Needham St
Ste 4
Newton Upper Falls, MA 02464
Phone (617) 232-0220

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1962546929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NEEDHAM ST",
            "address_2": "# 4",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641532",
            "telephone_number": "617-232-0220",
            "fax_number": "617-734-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NEEDHAM ST",
            "address_2": "# 4",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641532",
            "telephone_number": "617-232-0220",
            "fax_number": "617-734-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE D. SIEGEL, O.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-232-0220",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083510A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.