{"npi":"1790734010","type":"NPI-2","status":"active","name":{"display":"Optometric Providers INC","other":[],"organization_name":"OPTOMETRIC PROVIDERS INC","authorised_official":"Alerino Iacobbo"},"specialty":{"primary_taxonomy":"152W00000X","primary_taxonomy_description":"Optometrist","slug":"optometrist","schema_org_specialty":null,"all":[{"code":"152W00000X","description":"Optometrist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"100 STATE ST","city":"BOSTON","state":"MA","postal_code":"02109","country_code":"US","phone":"6177422076","fax":"6175579276"},{"purpose":"MAILING","street_1":"2921 ERIE BLVD E","city":"SYRACUSE","state":"NY","postal_code":"13224","country_code":"US","street_2":"OPTOMETRIC PROVIDERS INC","phone":"3154463145","fax":"3154457675"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"9781048","state":"MA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-05-06","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}