Kristin Stanley Rullo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4662 Issued in MA

Practice address

21 Worthen Road
Lexington, MA 02421

Phone

(781) 862-1828

Fax

(781) 863-9416

NPI assigned

Jul 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Lexington Eye Associates, IncGroup PAC ID 5698748986, 33 clinicians

Lexington Eye Associates - BidGroup PAC ID 8820315682, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stanleyrullo.kristin.epho@direct.partners.masshiway.net

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.

• Lexington Eye Associates - Bid

  • Ophthalmology Physician
  • Lexington, MA
  • NPI 1801204714
  Medicare reassignment Care Compare group NPD
• Lexington Eye Associates, Inc

  • Ophthalmology Physician
  • Lexington, MA
  • NPI 1467502757
  Medicare reassignment Care Compare group NPD
• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1467587881
  NPD
• Lexington Eye Associates, Inc.

  • Ophthalmology Physician
  • Lexington, MA
  • NPI 1194066001
  NPD

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1962666511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1828",
            "fax_number": "781-863-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WORTHEN ROAD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "781-862-1828",
            "fax_number": "781-863-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULLO",
        "first_name": "KRISTIN",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0728489",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Rossino, PTA
• Howard Rossman, PH.D.
• Ellen A Roth, M.S.W.
• Suraja Menon Roychowdhury, PHD, LICAC, MAOM
• Alicia R Ruby, NP
• John F Ryan, DMD
• Kristina A. Ryan, MAC,LAC
• Pamela S Ryle, MS, OTR, L
• Lauren Sabella
• Paul Sablone

• Optometrist in Lexington, MA
• Providers in Lexington, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.