Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jake Duclos Fiore, OD

Individual provider Optometrist · NPI 1104556232

Jake Duclos Fiore, OD is an Optometry in Waltham, Massachusetts. Qualified in 2022, 4 years ago. Practices with Ejc Eyecare LLC, a 3-clinician group. Licensed in Massachusetts.

Years since qualifying
4
Licensed in
MA
In the registry since
2022
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

289 Moody St
Waltham, MA 02453-5284
Phone: (781) 894-2127
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 5569 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104556232
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJune 13, 2022
Last updated in NPPESNovember 1, 2022
Certification dateOctober 21, 2022
Mailing address289 Moody St, Waltham, MA 02453-5284

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ejc Eyecare Llc — 3 clinicians
Accepts Medicare assignment Not indicated

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