Samira Sadat Mortazavi, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5631 Issued in MA

Practice address

243 Charles St
Boston, MA 02114-3096

Phone

(617) 573-4177

NPI assigned

Jun 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massachusetts Eye and Ear Associates, IncGroup PAC ID 4486540275, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Massachusetts Eye and Ear Associates, Inc.

  • Ophthalmology Physician
  • Boston, MA
  • NPI 1932574332

  Optometrist

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Massachusetts Eye and Ear Infirmary

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1639101751
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1992436786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTAZAVI",
        "first_name": "SAMIRA",
        "middle_name": "SADAT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Morse
• Ned Wilson Morse
• Samantha Morse, PA-C
• Chermaine L Morson, PHLEBOTOMIST
• Elizabeth A Mort, MD
• Koenraad Max Mortele
• Rachel Mortell, RN, FNP-C
• Jamie C. Mortellite, NURSE PRACTITIONER
• Peter J. Mortelliti, DDS.
• Lindsey Mortensen, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.