SOUTHBORO MEDICAL GROUP, INC. (NPI# 1578637724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578637724 |
| Entity Type | Organization |
| Organization Name | SOUTHBORO MEDICAL GROUP, INC. |
| Practice Address |
24 Newton St Southborough MA 01772-1215 |
| Practice Telephone | 5084815500 |
| Practice Fax Number | 5084603025 |
| Mailing Telephone | 5084815500 |
| Mailing Fax Number | 5084603025 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARVIN OSTROVSKY (PRESIDENT) |
| Authorized Official Telephone | 5084815500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS OPTOMETRY GROUP | 687740 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518032630 | Southboro Medical Group, Inc. | Psychologist | 24 Newton St, Southborough, MA 01772-1215 | 2006-11-22 |
| 1568473635 | Southboro Medical Group, Inc. | Social Worker | 24 Newton St, Southborough, MA 01772-1215 | 2006-08-11 |
| Street Address |
24 NEWTON ST |
| City | SOUTHBOROUGH |
| State | MA |
| Zip Code | 01772-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922094788 | Mark Finno, Md PC | Physical Medicine & Rehabilitation | 24 Newton St, Southborough, MA 01772-1215 | 2005-09-26 |
| 1649881699 | Jeremy Kw Spiewak | Pharmacist | 24 Newton St, Southborough, MA 01772-1215 | 2020-08-13 |
| 1437794716 | Reliant Medical Group, Inc | Optometrist | 24 Newton St, Southborough, MA 01772-1215 | 2019-11-11 |
| 1427516004 | Fnu Jomymerlythomas | Physical Therapist | 24 Newton St, Southborough, MA 01772-1215 | 2019-03-04 |
| 1629558960 | Amanda N Griffin | Nurse Practitioner | 24 Newton St, Southborough, MA 01772-1215 | 2018-08-16 |
| 1700322674 | Rosalind Gendreau | Registered Nurse | 24 Newton St, Southborough, MA 01772-1215 | 2017-01-16 |
| 1932584950 | Christine Ditullio | Nurse Practitioner | 24 Newton St, Southborough, MA 01772-1215 | 2015-07-21 |
| 1891175113 | Elizabeth Ann Minevich | Internal Medicine | 24 Newton St, Southborough, MA 01772-1215 | 2015-06-02 |
| 1164834750 | Southboro Medical Group, Inc | Specialist | 24 Newton St, Southborough, MA 01772-1215 | 2014-05-30 |
| 1588096754 | Shannon Leah Devlin | Registered Nurse | 24 Newton St, Southborough, MA 01772-1215 | 2013-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043854391 | Hiral Patel | Pharmacist | 150 Northnoro Road, Suite 4, Southborough, MA 01772 | 2019-10-30 |
| 1588188544 | Jennifer Foran | Behavior Technician | 33 Turnkpike Road, Southborough, MA 01772 | 2017-08-01 |
| 1588184402 | Lise Mary Gallo | Behavioral Analyst | 16 Clifford St, Southborough, MA 01772 | 2017-06-21 |
| 1437508322 | Kristen Lomker | Pharmacist | 155 Northborough Rd, Southboro, MA 01772 | 2016-06-10 |
| 1679841829 | Scott Adam Canter | Acupuncturist | 64 William Onthank Lane, Southborough, MA 01772 | 2011-12-02 |
| 1396966206 | Umer Sayeed Shah | Surgery | 2 Parkcentral Drive Suite 210, Avc / Acc, Southborough, MA 01772 | 2007-05-01 |
| 1982636411 | Armineh Mirzabegian | Internal Medicine | Southboro Medical Group, 24 Newton Street, Southboro, MA 01772 | 2006-07-07 |
| 1336197508 | Lisa M Hassler | Pediatrics | 24 Newton Street, Southboro Medical Group, Southboro, MA 01772 | 2006-05-04 |
| 1295714640 | Robin K Morgan | Physical Therapist | 28 Newton St, Southborough, MA 01772 | 2006-01-13 |
| 1528562998 | Emily Marie Bagley | Student in an Organized Health Care Education/Training Program | 33 Turnpike Rd, Southborough, MA 01772 | 2018-03-21 |
| Find all providers in zip 01772 | ||||
| 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 |
|---|---|---|---|---|
| 1184141327 | Qian Ru Cheng | Optometrist | 30 Turnpike Rd Ste 7, Southborough, MA 01772-2115 | 2017-08-28 |
| 1013977685 | Paul E Levine | Optometrist | 30 Turnpike Rd, Suite 7, Southborough, MA 01772-2114 | 2006-03-27 |
| 1437794716 | Reliant Medical Group, Inc | Optometrist | 24 Newton St, Southborough, MA 01772-1215 | 2019-11-11 |
| 1659880359 | Lindsay Swenson | Optometrist | 30 Turnpike Rd Ste 7, Southborough, MA 01772-2115 | 2017-09-25 |
| 1750827374 | Tsungming Hung | Optometrist | 30 Turnpike Rd, Suite 7, Southborough, MA 01772-2114 | 2017-01-07 |
| 1568546968 | Vision Care Specialists, P.C. | Optometrist | 30 Turnpike Rd, Suite 7, Southborough, MA 01772-2115 | 2006-10-24 |
| 1902992886 | John Mark Abbondanza | Optometrist | 30 Turnpike Rd, Suite 7, Southborough, MA 01772-2114 | 2006-10-05 |
| 1275635112 | Asha Sherring | Optometrist | 24 Newton St, Southborough, MA 01772-1215 | 2006-09-01 |
| 1427078120 | Elizabeth A. Askew | Optometrist | 24 Newton St, Southborough, MA 01772-1215 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336030 | Nicole Leo | Optometrist | 18 Dana Rd, Boxford, MA 01921-2661 | 2020-11-06 |
| 1063019446 | Appleton Eye Associates PC | Optometrist | 21 Market Street, Suite 100, Ipswitch, MA 01938 | 2020-10-08 |
| 1083221352 | Myeyedr Optometry of Massachusetts P C | Optometrist | 495 Cabot St Ste 1, Beverly, MA 01915-2515 | 2020-09-30 |
| 1750994448 | Compassion Eye Care LLC | Optometrist | 127 Eastern Ave Ste 5, Gloucester, MA 01930-1870 | 2020-08-24 |
| 1487264404 | Arash Namiranian | Optometrist | 18 Ashland Woods Ln, Ashland, MA 01721-4418 | 2020-08-04 |
| 1588272181 | Angela Ciocca Od Pllc | Optometrist | 1176 Memorial Dr Ste B, Chicopee, MA 01020-3958 | 2020-07-20 |
| 1588289078 | Ying Wu-freeman | Optometrist | 30 Converse Ave, Malden, MA 02148-7508 | 2020-06-10 |
| 1881218634 | Alexa Caruso | Optometrist | 1191 Chestnut St Ste 707, Newton, MA 02464-1351 | 2020-06-07 |
| 1811510795 | William Cheon | Optometrist | 84 Matheson Dr, Marlborough, MA 01752-4597 | 2020-05-26 |
| 1790314557 | Kirsten Brady | Optometrist | 10 Fairfield St Apt 3, Boston, MA 02116-1666 | 2020-04-03 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHBOROUGH |
| Zip Code | 01772 |
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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.