Active NPI
Charlton Optical
- Eyewear Supplier
- Charlton, MA
National Provider Identifier
1962688051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- License
- 4511
- Legal business name
- CHARLTON OPTICAL
- Practice address
- 109-6 Masonic Home Road
Charlton, MA 01507 - Phone
- (508) 248-1188
- Fax
- (508) 248-5128
- NPI assigned
- Jan 18, 2008
- Last updated
- Jan 18, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Peter Maly, R.D.O.
- Title
- Owner
- Phone
- (508) 248-1188
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | 4511 | MA | Primary |
Addresses
Primary practice location
109-6 Masonic Home Road
Charlton, MA 01507
Mailing address
PO Box 194
109-6 Masonic Home Road
Charlton, MA 01507-0194
Phone (508) 248-1188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930081508 | MA | DME Supplier - Optician | 9537289418 | Practice locations: Charlton, MA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Sturbridge, MA
- NPI 1811277163
-
- Optometrist
- Sturbridge, MA
- NPI 1306295274
-
- Optometrist
- Charlton, MA
- NPI 1588728216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200614400000",
"number": "1962688051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 194",
"address_2": "109-6 MASONIC HOME ROAD",
"city": "CHARLTON",
"state": "MA",
"postal_code": "015070194",
"telephone_number": "508-248-1188",
"fax_number": "508-248-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109-6 MASONIC HOME ROAD",
"city": "CHARLTON",
"state": "MA",
"postal_code": "01507",
"telephone_number": "508-248-1188",
"fax_number": "508-248-5128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLTON OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-18",
"last_updated": "2008-01-18",
"status": "A",
"authorized_official_last_name": "MALY",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "508-248-1188",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.D.O."
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "MA",
"license": "4511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.