NPIMap

Organization Active NPI

Rettoc Optical Service

Doing business as Parkway Optical

  • Eyewear Supplier
  • Revere, MA
National Provider Identifier
1982700043
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
3044 Issued in MA
Legal business name
RETTOC OPTICAL SERVICE
Doing business as
Parkway Optical
Practice address
80 Broadway
Revere, MA 02151-5305
Phone
(781) 289-7929
NPI assigned
Sep 16, 2006
Last updated
Sep 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Dr. Janis M Cotter, O.D.NPI 1104922202
Title
President
Phone
(781) 289-7929

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)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 3044 MA Primary

Addresses

Primary practice location

80 Broadway
Revere, MA 02151-5305

Mailing address

80 Broadway
Revere, MA 02151-5305
Phone (781) 289-7929

Other identifiers 4

IdentifierTypeStateIssuer
CQ029OtherNYEMPIRE BCBS
000122654OtherMABLUE CROSS/MEDEX/PARKWAY
1511327MedicaidMA
0000Q03964OtherMABCBS/MEDEX/RETTOC

Other names 1

  • Parkway Optical Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1982700043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515305",
            "telephone_number": "781-289-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515305",
            "telephone_number": "781-289-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETTOC OPTICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "COTTER",
        "authorized_official_first_name": "JANIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-289-7929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MA",
            "license": "3044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "CQ029",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/MEDEX/PARKWAY",
            "identifier": "000122654",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1511327",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/MEDEX/RETTOC",
            "identifier": "0000Q03964",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkway Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.