Provider Demographics
NPI:1194760389
Name:KAIM, MATTHEW J (OD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:KAIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:50 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-2649
Mailing Address - Country:US
Mailing Address - Phone:617-846-1734
Mailing Address - Fax:617-846-3292
Practice Address - Street 1:50 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-2649
Practice Address - Country:US
Practice Address - Phone:617-846-1734
Practice Address - Fax:617-846-3292
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3084152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0011850OtherNEIGHBORHEALTH PLAN
MDW20357OtherBLUE CROSS
114365OtherEYE MED
MA2517744OtherAETNA
MA0392103Medicaid
MA732780OtherTUFTS
MAW15952OtherBLUE CROSS
14354OtherSPECTERA
7582OtherDAVIS VISION
MAAA10590OtherHARVARD PILGRIM
MA3084OtherVISION BENEFITS OF AMERIC
MA22+00522OtherUNITED HEALTHCARE
MA0392103Medicaid
MAW15952OtherBLUE CROSS
MA0011850OtherNEIGHBORHEALTH PLAN