1336217033 NPI number — MICHAEL J. MCCARTY O.D. PC

Table of content: (NPI 1336217033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336217033 NPI number — MICHAEL J. MCCARTY O.D. PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL J. MCCARTY O.D. PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336217033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1022 ASHLEY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02745-2416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-998-5411
Provider Business Mailing Address Fax Number:
508-985-9047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1022 ASHLEY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02745-2416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-998-5411
Provider Business Practice Location Address Fax Number:
508-985-9047
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCARTY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OPTOMITRIST
Authorized Official Telephone Number:
508-998-5411

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  2260 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000023113 . This is a "BMC NB" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017348451 . This is a "GIC IDEMITY PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 15052 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 731297 . This is a "TUFTS MEDICARE PREFERRED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: W15560 . This is a "BCBC MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: W15560 . This is a "BLUE CHIP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000030319 . This is a "BMC FR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0004719 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017348451 . This is a "GROUP INS. SERVICE CTR." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22-01019 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: W15560 . This is a "BCBS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017348451 . This is a "ANTHEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 731297 . This is a "TUFTS HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017348451 . This is a "VISION BENEFITS OF AMER." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0310557 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000030320 . This is a "BMC T" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017348451 . This is a "VISION SERVICE PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 15052 . This is a "HARVARD PILGRIM 1ST SEN." identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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