Boston Eye Blink LLC
Organization Active NPI Optometrist · Dedham, MA
NPI 1992358048 · NPPES record last updated Mar 27, 2023
Key facts
- NPI
- 1992358048
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 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
- Organization subpart
- No
Authorized official
- Name
- Yueran Yan, OD
- Title
- Manager
- Phone
- (617) 651-6662
Practitioners 1
-
Yueran Yan, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230531001556 | MA | Part B Supplier - Clinic/Group Practice | 7416314877 |
Receives reassigned benefits from 1 practitioner Practice locations: Dedham, MA |
National Provider Directory
Locations
200 Legacy Blvd
Dedham, MA 02026
Phone (617) 651-6662
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
200 Legacy Blvd
Dedham, MA 02026-2653
Mailing address
200 Legacy Blvd
Dedham, MA 02026-2653
Phone (617) 651-6662
Other providers in Dedham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.