Amelia Colby Burns, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5507 Issued in MA

Practice address

4110 Mystic Valley Pkwy
Medford, MA 02155-6931

Phone

(781) 350-7008

NPI assigned

May 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lickteig Family Eyecare PCGroup PAC ID 6002096328, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lickteig Family Eyecare PC

  • Optometrist
  • Dedham, MA
  • NPI 1063720498
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726963200000",
    "number": "1982227146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SWANTON ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901919",
            "telephone_number": "617-605-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 MYSTIC VALLEY PKWY",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556931",
            "telephone_number": "781-350-7008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Milk St",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Methven",
            "state": "MA",
            "postal_code": "01844",
            "country_code": "US",
            "telephone_number": "978-984-6933",
            "fax_number": "978-984-7158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "AMELIA",
        "middle_name": "COLBY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-09-22",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaa Bukhari
• Alanna Bunzel
• Michael Buonopane, ATC
• Johanna Burke, M.D.
• Caitlyn Burkhardt, PTA
• Courtney Lynn Burns
• Edward P Butler, MD
• Kathleen Anne Butler, R.D.
• C.M.F.-Cranio-Maxillofacial Surgery Associates
• C.M.F.-Cranio-Maxillofacial Surgery Associates

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2024; 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.