AMY LEE CUOMO O.D.
NPI 1235588187
Optometrist in Cambridge, MA

NPI Status: Active since June 10, 2016

Contact Information

19 DUNSTER ST
CAMBRIDGE, MA
ZIP 02138
Phone: (617) 354-5590

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  • Individual
  • Female
  • Years of Experience 9
  • Optometrist
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About AMY CUOMO

Amy Cuomo is a provider established in Cambridge, Massachusetts and her medical specialization is Optometrist with more than 9 years of experience. She graduated from New England College Of Optometry in 2015. The healthcare provider is registered in the NPI registry with number 1235588187 assigned on June 2016. The practitioner's primary taxonomy code is 152W00000X with license number 5242 (MA). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1235588187
Provider Name
AMY LEE CUOMO O.D.
Other Name
AMY LEE RAYLA OD
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
19 DUNSTER ST CAMBRIDGE, MA 02138
Location Phone
(617) 354-5590
Mailing Address
19 DUNSTER ST CAMBRIDGE, MA 02138
Mailing Phone
(617) 354-5590
Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Graduation Year
2015
Is Sole Proprietor?
No
Enumeration Date
06-10-2016
Last Update Date
08-02-2020
Code Navigator

Amy Cuomo is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The typical physician office visit costs for Medicare beneficiaries in this area are: $37.51 for a new patient copayment and $20.59 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Optometrist

Taxonomy Code
152W00000X
Type
Eye and Vision Services Providers
License No.
5242
License State
MA
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Blue Cross and Blue Sheld

    • Anthem Bronze Blue Connection EPO 7000/50%/8000 w/HSA - EPO
    • Anthem Bronze Blue Connection EPO 8500/50%/9450 - EPO
    • Anthem Gold Blue Connection EPO 1000/20%/7500 - EPO
    • Anthem Gold Blue Connection EPO 2000/0%/6500 RxD - EPO
    • Anthem Gold Blue Connection EPO 2000/10%/4725 w/HSA - EPO
    • Anthem Gold Blue Connection EPO 2000/10%/8000 - EPO
    • Anthem Gold Blue Connection EPO 2000/10%/8000 WH - EPO
    • Anthem Gold Blue Connection EPO 2000/20%/4725 w/HSA - EPO
    • Anthem Gold Blue Connection EPO 3000/0%/5500 RxD - EPO
    • Anthem Gold Blue Connection EPO 500/25%/7500 - EPO
  • Anthem Blue Cross and Blue Shield

    • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
    • Anthem Bronze Access Blue New England HMO 8500/50%/9450 - HMO
    • Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
    • Anthem Bronze Pathway X HMO 8500/50%/9450 - HMO
    • Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
    • Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/4725 w/HSA - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/8000 - HMO
    • Anthem Gold Access Blue New England HMO 2000/10%/8000 WH - HMO
    • Anthem Gold Access Blue New England HMO 2000/20%/4725 w/HSA - HMO
  • Blue Cross and Blue Shield of Illinois

    • Blue Choice Preferred Bronze PPO℠ 201 - PPO
    • Blue Choice Preferred Bronze PPO℠ 202 - PPO
    • Blue Choice Preferred Bronze PPO℠ 601 - Rx Copays - PPO
    • Blue Choice Preferred Bronze PPO℠ 701 - Rx Copays - PPO
    • Blue Choice Preferred Bronze PPO℠ 708 - PPO
    • Blue Choice Preferred Gold PPO℠ 204 - Rx Copays - PPO
    • Blue Choice Preferred Gold PPO℠ 707 - PPO
    • Blue Choice Preferred Security PPO℠ 200 - PPO
    • Blue Choice Preferred Silver PPO℠ 203 - PPO
    • Blue Choice Preferred Silver PPO℠ 706 - PPO
  • Blue Cross and Blue Shield of Montana

    • Blue Focus Bronze POS℠ 205 - POS
    • Blue Focus Bronze POS℠ 705 - POS
    • Blue Focus Bronze POS℠ 708 - POS
    • Blue Focus Gold POS℠ 207 - POS
    • Blue Focus Gold POS℠ 707 - POS
    • Blue Focus Silver POS℠ 206 - POS
    • Blue Focus Silver POS℠ 706 - POS
    • Blue Preferred Bronze PPO℠ 201 - PPO
    • Blue Preferred Bronze PPO℠ 202 - PPO
    • Blue Preferred Bronze PPO℠ 301 - PPO
  • Blue Cross and Blue Shield of Oklahoma

    • Blue Advantage Bronze PPO℠ 801 - PPO
    • Blue Advantage Bronze PPO℠ 202 - PPO
    • Blue Advantage Bronze PPO℠ 203 - PPO
    • Blue Advantage Gold PPO℠ 309 - PPO
    • Blue Advantage Gold PPO℠ 604 - PPO
    • Blue Advantage Gold PPO℠ 803 - PPO
    • Blue Advantage Silver PPO℠ 204 - PPO
    • Blue Advantage Silver PPO℠ 501 - PPO
    • Blue Advantage Silver PPO℠ 605 - PPO
    • Blue Advantage Silver PPO℠ 802 - PPO
  • Blue Cross and Blue Shield of Texas

    • Blue Advantage Bronze HMO℠ 204 - HMO
    • Blue Advantage Bronze HMO℠ 301 - HMO
    • Blue Advantage Bronze HMO℠ 302 - HMO
    • Blue Advantage Bronze HMO℠ 707 - HMO
    • Blue Advantage Gold HMO℠ 206 - HMO
    • Blue Advantage Gold HMO℠ 603 - HMO
    • Blue Advantage Gold HMO℠ 706 - HMO
    • Blue Advantage Plus Bronze℠ 303 - POS
    • Blue Advantage Plus Bronze℠ 305 - POS
    • Blue Advantage Plus Bronze℠ 707 - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Amy Cuomo is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4385938679

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210726001347

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 02138 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $150.04
  • Minimum New Patient Price $66.28
  • Maximum New Patient Price $197.76
  • Average New Patient Copayment $37.51
  • Minimum New Patient Copayment $16.57
  • Maximum New Patient Copayment $49.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $82.39
  • Minimum Established Patient Price $21.28
  • Maximum Established Patient Price $162.14
  • Average Established Patient Copayment $20.59
  • Minimum Established Patient Copayment $5.32
  • Maximum Established Patient Copayment $40.53

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1235588187
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
226510816116
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 6 + 5 + 1 + 0 + 8 + 1 + 6 + 1 + 1 + 6 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1235588187 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1790874667MS. LAUREN DICKERMAN O.D.
Individual
Optometrist19 DUNSTER ST
CAMBRIDGE, MA 02138
(617) 354-5590
1962523795DR. BRENDA CRONIN O.D.
Individual
Optometrist19 DUNSTER ST
CAMBRIDGE, MA 02138
(617) 354-5590
1003002155HARVARD SQUARE EYE CARE P.C.
Organization
Optometrist19 DUNSTER ST
CAMBRIDGE, MA 02138
(617) 354-5590
1881092666 JANE LAM O.D.
Individual
Optometrist19 DUNSTER ST
CAMBRIDGE, MA 02138
(617) 354-5590

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235588187, enumerated in the NPI registry as an "individual" on June 10, 2016

The provider is located at 19 Dunster St Cambridge, Ma 02138 and the phone number is (617) 354-5590

The provider's speciality is Optometrist with taxonomy code 152W00000X

The provider has more than 9 years of experience. She graduated from New England College Of Optometry in 2015.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 21, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Medicare beneficiaries should expect a typical cost of $150.04 with an average copayment of $37.51 for new patient appointments. Established patients should expect a typical charge of $82.39 and an average copayment of 20.59. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 10, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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