Individual provider Active NPI

Kristin A Glavine, O.D.

  • Optometrist
  • Greenfield, MA
National Provider Identifier
1962632091
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4741 Issued in MA
Practice address
33 Riddell St
Greenfield, MA 01301-2025
Phone
(413) 774-7016
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4741 MA Primary

Addresses

Primary practice location

33 Riddell St
Greenfield, MA 01301-2025

Mailing address

33 Riddell St
Greenfield, MA 01301-2025
Phone (413) 774-7016

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
I20091007000551 MA Practitioner - Optometry 8527104462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longwood Eye LLCGroup PAC ID 0143632802, 16 clinicians

Practice addresses (Care Compare)

354 Main St
Gardner, MA 01440-3055
Phone (978) 632-4920

Merit-based Incentive Payment System (MIPS)

Final score
94.01 of 100Reported as group
Quality
92.29
Improvement activities
40
Cost
73.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4741MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Longwood Eye, LLC Optometrist CurrentSince Jan 1, 2021 Accepting new patients

Locations

33 Electric Ave
Ste 2
Fitchburg, MA 01420

354 Main St
Gardner, MA 01440
Phone (412) 774-7016

33 Riddell St
Greenfield, MA 01301
Phone (413) 772-0853

Interoperability endpoints

  • Direct secure messaging: kristinglavine@longwood.imwdirect.com

Organizations & group practices 1

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1962632091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 RIDDELL ST",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013012025",
            "telephone_number": "413-774-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 RIDDELL ST",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013012025",
            "telephone_number": "413-774-7016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVINE",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, MA

Sources for this page

Verify at the official NPI Registry.