Dr. Elaine Icban
Optometrist

Address: 4199 Washington St, Suite 2, Boston, MA 02131-1733
Phone: 6175875520

Dr. Elaine Icban (NPI# 1609814177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1609814177
Entity Type Individual
Full Name Dr. Elaine Icban
Credential O.D.
Gender Female
Practice Address 4199 Washington St
Suite 2
Boston
MA 02131-1733
Practice Telephone 6175875520
Practice Fax Number 6175875521
Mailing Address 930 Commonwealth Ave
Suite 2a
Boston
MA 02215-1274
Mailing Telephone 6175875511
Mailing Fax Number 6175875514
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-06-04
Last Update Date 2009-03-05

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 152W00000X Optometrist Eye and Vision Services Providers 4677 MA

Other Provider Identifier

State Identifier Issuer Type Code
MA 2988926 OTHER UNITED HEALTH CARE
MA 95191001 OTHER NETWORK HEALTH
MA 7733882 OTHER AETNA
MA AA131399 OTHER HARVARD PILGRIM

Physician Overview

NPI 1609814177
PAC ID by PECOS 4385645456
Professional Enrollment ID I20090327000039
Full Name Elaine Icban
Organization Legal Name UNIVERSITY EYE CARE LLC
Phone Number 7813267359
Gender F
Credential OD
Medical School UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduation Year 2005
Primary Specialty OPTOMETRY
Group Practice PAC ID 0749586410
Number of Group Practice Members 2
Accepts Medicare Assignment Y
Report Quality Measures Y

Office Location

Street Address 4199 WASHINGTON ST
SUITE 2
City BOSTON
State MA
Zip Code 02131-1733

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992191167 Juliana I Castedo Family Medicine 4199 Washington St, Boston, MA 02131 2015-04-14
1073521746 Paul B Ahn Pediatrics 4199 Washington St, Suite 1, Boston, MA 02131-1733 2006-08-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760952881 Patricia J Dunn Social Worker 51 Braden Street, Roslindale, MA 02131 2018-12-01
1750864518 Maria T. Alvarado Social Worker 18 Manusr Street, Roslindale, MA 02131 2018-09-07
1306342951 Roslindale Center Chiropractic Inc Chiropractor 17 Corinth St, Roslindale, MA 02131 2018-04-03
1629511241 Maddy Morrin Student in an Organized Health Care Education/Training Program 17 Archdale Rd, Roslindale, MA 02131 2016-11-30
1497143762 Priority Home Care Services LLC Home Health 43 Cummins High Way, Suite 3, Boston, MA 02131 2015-01-08
1841610078 Ryan Kennedy Student in an Organized Health Care Education/Training Program 478 American Legion Highway, Roslindale, MA 02131 2014-04-28
1780011833 Casey A Pagliaro Marriage & Family Therapist 4238 Washington Street, Suite 316, The Leggett Group, Roslindale, MA 02131 2013-10-03
1902238025 Ann Wheeler Student in an Organized Health Care Education/Training Program Thlw 780 American Legion Highway, Roslindale, MA 02131 2013-07-31
1851608095 Christina Apostolidou Registered Nurse 385 Poplar Street, Roslindale, MA 02131 2010-09-09
1366766586 Atlantic Rehabilitation Services, Inc Chiropractor 4197 Washington St., Roslindale, MA 02131 2010-03-17
Find all providers in zip 02131

Taxonomy Information

Taxonomy Code 152W00000X
Grouping Eye and Vision Services Providers
Classification Optometrist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1770097040 Doug Haigh Eye Care LLC Optometrist 588 E 7th St, Boston, MA 02127-4224 2017-11-25
1215479704 Kristen Leigh Kerber Optometrist 930 Commonwealth Avenue, Suite 2a, Boston, MA 02215-1220 2016-11-15
1437535895 Xueling Song Optometrist 155 Federal St # 150, Boston, MA 02110-1727 2015-08-07
1699165357 Azadeh Kelly Optometrist 33 Broad St Lbby 2, Boston, MA 02109-4229 2015-02-02
1164825428 Rachel Bates Optometrist 513 Beacon St, Apt 10, Boston, MA 02215-2309 2014-10-01
1407269319 Ellen Sun Optometrist 37 Newbury St, Boston, MA 02116-3100 2014-06-09
1457762890 Shazia Ahmed Md PC Optometrist 221 Massachusetts Ave, #710, Boston, MA 02115-3504 2014-05-19
1326460916 2020, Inc Optometrist 222 Berkeley St Fl 12, (note: This Is A Mobile-only Practice), Boston, MA 02116-3733 2014-01-15
1396094249 Vania Yip Optometrist 83 Newbury St Fl 2, Boston, MA 02116-3284 2012-09-06
1588929038 Justin Bobak Asgarpour Optometrist 454 Beacon St Apt 5f, Boston, MA 02115-1007 2012-07-11
Find all providers in BOSTON

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City BOSTON
Zip Code 02131

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Dataset Information

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.

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