MEDICARE: DR. DAVID J SCHURGIN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2345T	MA
2	152WL0500X	Low Vision Rehabilitation Optometrist	2345T	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00112641	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	W15232	OTHER	MA	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	001333518	OTHER		HIGHMARK BCBS
5	151581	OTHER	MA	HARVARD/PILGRIMHEALTHCARE
6	3236433	OTHER		AETNA

General Provider Information

NPI Number	:	1235135781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J SCHURGIN O.D.

Provider Business Mailing Address
First Line	:	224 PARK ST
Second Line	:	APT C5
City	:	STONEHAM
State	:	MA
Zip	:	02180-2758
Country	:	US
Telephone Number	:	781-438-8407
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 PARK ST
Second Line	:	APT C5
City	:	STONEHAM
State	:	MA
Zip	:	02180-2758
Country	:	US
Telephone Number	:	781-438-8407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	12/01/2025

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Directions to “ DR. DAVID J SCHURGIN O.D.” Practice Location

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