Individual provider Active NPI

Lena Alisa Desjardins, O.D.

  • Optometrist
  • Winchester, MA
National Provider Identifier
1962841361
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4964 Issued in MA
Practice address
888 Main St
Winchester, MA 01890-1913
Phone
(781) 729-4553
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4964 MA Primary

Addresses

Primary practice location

888 Main St
Winchester, MA 01890-1913

Mailing address

888 Main St
Winchester, MA 01890-1913
Phone (617) 338-7200

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
I20140128001026 MA Practitioner - Optometry 7810126687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Eye Care LLCGroup PAC ID 2264880020, 2 clinicians

Practice addresses (Care Compare)

888 Main St
Winchester, MA 01890-1913
Phone (781) 729-4553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Eye Care LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Winchester Optical Inc PastSince Jun 9, 2024 Accepting new patients

Locations

888 Main St
Winchester, MA 01890
Phone (781) 729-2660

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1962841361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 MAIN ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901913",
            "telephone_number": "617-338-7200",
            "fax_number": "781-334-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 MAIN ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901913",
            "telephone_number": "781-729-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "LENA",
        "middle_name": "ALISA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

Verify at the official NPI Registry.