BOSTON UNIVERSITY EYE ASSOCIATES, INC. (NPI# 1154317865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154317865 |
| Entity Type | Organization |
| Organization Name | BOSTON UNIVERSITY EYE ASSOCIATES, INC. |
| Practice Address |
2005 Bay St Ste 206 Taunton MA 02780-1085 |
| Practice Telephone | 5088237473 |
| Practice Fax Number | 5088243830 |
| Mailing Telephone | 5088237473 |
| Mailing Fax Number | 5088243830 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | DR. STEPHEN P. CHRISTIANSEN (CHAIRMAN) |
| Authorized Official Telephone | 6174142020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | N/A | MA | Eye and Vision Services Providers |
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
N/A | MA | Ambulatory Health Care Facilities |
| Y | 207W00000X | Ophthalmology | N/A | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS (FACILITY) | 600685 | 01 |
| MA | BCBS (FACILITY) | M88004 | 01 |
| MA | TUFTS (PRACTICE) | 615277 | 01 |
| MA | BCBS (OPTOMETRY) | W20231 | 01 |
| MA | AETNA | 93923 | 01 |
| MA | 9766162 | 05 | |
| MA | BCBS (MD'S) | M15401 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679531610 | Boston University Eye Associates, Inc. | Clinic/Center | 90 New State Hwy, Raynham, MA 02767-1433 | 2006-05-01 |
| 1285691337 | Boston University Eye Associates, Inc. | Optometrist | 850 Harrison Ave # Acc-3, Boston, MA 02118-4001 | 2006-05-01 |
| 1780866087 | Boston University Eye Associates, Inc. | Optometrist | 2005 Bay St, Suite 201, Taunton, MA 02780-1085 | 2007-11-29 |
| Street Address |
2005 BAY ST STE 206 |
| City | TAUNTON |
| State | MA |
| Zip Code | 02780-1085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013903822 | Babak Eliassi-rad | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2005-09-27 |
| 1417377136 | Anna Kupcha | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2014-04-21 |
| 1407295488 | Rohini Rao | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780 | 2013-06-22 |
| 1053654004 | Elizabeth Shanika Esparaz | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2013-03-28 |
| 1811252190 | Jenna Rochelle Titelbaum | Optometrist | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2012-07-12 |
| 1023377306 | Matthew Leidl | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2012-05-08 |
| 1033484159 | Xuejing Chen | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2012-03-22 |
| 1558660340 | Alberto Giuseppe Distefano | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780 | 2011-03-20 |
| 1972816452 | Michele Mchale | Optometrist | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2010-07-26 |
| 1568788040 | Kara C. Lamattina | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2010-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766338 | Peter A. Bertelli | Registered Nurse | Attn: Peter A. Bertelli, Rn, 70 Main Street, Taunton, MA 02780 | 2020-03-26 |
| 1790321388 | Daniel Bettencourt | Counselor | 1 Washington St. Taunton, Ma 02780, Taunton, MA 02780 | 2019-11-19 |
| 1629620067 | Lauren Mulkern | Behavior Technician | 36 Saints Way, Taunton, MA 02780 | 2019-07-16 |
| 1154891737 | Sara Keller | Physical Therapist | 68 Dean Street, Taunton, MA 02780 | 2018-11-27 |
| 1366931594 | Alicia Marie Donahue | Optometrist | 2005 Bay Street Suite 206, Taunton, MA 02780 | 2018-05-03 |
| 1922522879 | Kathryn Louise Drapeau | Registered Nurse | 17 Patriot Road, Taunton, MA 02780 | 2017-08-02 |
| 1174057913 | Marie Lorquet | Registered Nurse | 111 Bay St, Taunton, MA 02780 | 2017-04-19 |
| 1912351693 | Samantha Hollis | Social Worker | 126 Dighton Avenue, Taunton, MA 02780 | 2016-04-19 |
| 1689030843 | Alexandra Rhae Lynn | Counselor | 1 Washington St., Taunton, MA 02780 | 2016-01-04 |
| 1386058261 | Carmen Iris Rivera | Registered Nurse | 111 Worcester St, Taunton, MA 02780 | 2014-06-18 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235125964 | Jules L Baum | Ophthalmology | 2005 Bay St, Suite 201, Taunton, MA 02780-1085 | 2005-09-27 |
| 1013903822 | Babak Eliassi-rad | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2005-09-27 |
| 1417377136 | Anna Kupcha | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2014-04-21 |
| 1407295488 | Rohini Rao | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780 | 2013-06-22 |
| 1053654004 | Elizabeth Shanika Esparaz | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2013-03-28 |
| 1023377306 | Matthew Leidl | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2012-05-08 |
| 1033484159 | Xuejing Chen | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2012-03-22 |
| 1558660340 | Alberto Giuseppe Distefano | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780 | 2011-03-20 |
| 1689992489 | Neil Mahesh Vyas | Ophthalmology | 2005 Bay St, Suite 201, Taunton, MA 02780-1085 | 2010-05-04 |
| 1568788040 | Kara C. Lamattina | Ophthalmology | 2005 Bay St Ste 206, Taunton, MA 02780-1085 | 2010-04-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.