Provider Demographics
NPI:1962414714
Name:BURLINGTON VISION ASSOCIATES INC
Entity type:Organization
Organization Name:BURLINGTON VISION ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:TRAVEIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-837-3790
Mailing Address - Street 1:385 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803
Mailing Address - Country:US
Mailing Address - Phone:508-837-3790
Mailing Address - Fax:781-272-0366
Practice Address - Street 1:385 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803
Practice Address - Country:US
Practice Address - Phone:781-272-9365
Practice Address - Fax:781-272-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA3790152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0369748Medicaid
03790OtherVISION BENEFITS OF AMER
66285OtherFALLON
0021531OtherNEIGHBORHOOD HEALTH
152293OtherFIRST SENIORITY
152293OtherHPHC
40860OtherDAVIS
1784321OtherUNITED HEALTHCARE
MAW20254OtherBCBS
MA760854OtherTUFTS
94005342OtherPRIVATE HEALTHCARE SYSTEM
MA3790OtherEYEMED
U56949Medicare UPIN
MA4345730001Medicare NSC
MAW26004Medicare PIN