Boston Eye Blink LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BOSTON EYE BLINK LLC

Practice address

200 Legacy Blvd
Dedham, MA 02026-2653

Phone

(617) 651-6662

NPI assigned

Jul 18, 2019

Last updated

Mar 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yueran Yan, ODNPI 1497307193

Title

Manager

Phone

(617) 651-6662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

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.

• Yueran Yan, OD

  • Optometrist
  • Dedham, MA
  • NPI 1497307193
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1992358048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LEGACY BLVD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262653",
            "telephone_number": "617-651-6662",
            "fax_number": "781-459-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LEGACY BLVD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262653",
            "telephone_number": "617-651-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON EYE BLINK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "YUERAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-651-6662",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alonso Bolivar, PA-C
• Samantha Maria Bolivar, PHARM.D., RPH.
• Michelle Bolser, MA, PCC, NBC-HWC
• Rebekah Ann Boral, DMD
• Pietro Bortoletto
• Boston Forensic Associates LLC
• Boston Neurobehavioral Associates
• Boston Sports & Shoulder Center,LLC (Boston Sports & Shoulder Center)
• Boston Sports Medicine and Research Institute LLC
• Boston Woman's Hospital

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.

Verify at the official NPI Registry.