DR ANTHONY W IRACA OF MEDFORD INC (NPI# 1396933826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396933826 |
| Entity Type | Organization |
| Organization Name | DR ANTHONY W IRACA OF MEDFORD INC |
| Practice Address |
4110 Mystic Valley Parkway Medford MA 02155 |
| Practice Telephone | 7813911195 |
| Practice Fax Number | 7813957875 |
| Mailing Telephone | 7813911195 |
| Mailing Fax Number | 7813957875 |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | DR. ANTHONY WALTER IRACA JR. (PRESIDENT) |
| Authorized Official Telephone | 7813911195 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
3432 | MA | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 3432 | MA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BCBS | W20411 | 01 |
| Street Address |
4110 MYSTIC VALLEY PARKWAY |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417339359 | Angela Marie Dedionisio | Optometrist | 38 Rossanley Dr, Medford, OR 97501 | 2015-06-28 |
| 1508243239 | Bastian Eyecare Professionals | Optometrist | 12 Revere Pl, Medford, MA 02155-3903 | 2015-05-01 |
| 1700216090 | All Eye Care At Davis, Inc | Optometrist | 63 Station Lndg, Att. Dr Dzenana Idrizovic, Medford, MA 02155-5192 | 2013-11-22 |
| 1518246883 | Yan Lu | Optometrist | 278 Middlesex Ave, Medford, MA 02155-5066 | 2011-08-04 |
| 1821307182 | Diane Marie Shaver | Optometrist | 1600 N Riverside Ave Unit 2027, Medford, OR 97501-4665 | 2010-10-04 |
| 1659491777 | Stephen Allen Barnes | Optometrist | 3639 Crater Lake Hwy, Medford, OR 97504-9259 | 2007-03-30 |
| 1700916251 | Wayne Leroy Knight | Optometrist | 120 Route 70, Medford, NJ 08055-9504 | 2007-03-06 |
| 1477692655 | Kimberly Tischner | Optometrist | 73 S Main Street, Medford, NJ 08055 | 2007-02-05 |
| 1164589230 | Steven Paul Mullins | Optometrist | 1740 Delta Waters Rd, Suite 100, Medford, OR 97504-9175 | 2007-01-02 |
| 1578625612 | Barry Andrew Clegg | Optometrist | 2352 Poplar Dr, Medford, OR 97504-5297 | 2006-12-14 |
| Find all providers in MEDFORD | ||||
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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.