Individual provider Active NPI

Terri L Cyr, DR OD

  • Optometrist
  • Wallingford, CT
National Provider Identifier
1003022377
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2264 Issued in CT
Practice address
930 N Colony Rd
Suite I
Wallingford, CT 06492-2471
Phone
(203) 265-4362
Fax
(203) 265-0415
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2264 CT Primary

Addresses

Primary practice location

930 N Colony Rd
Suite I
Wallingford, CT 06492-2471

Mailing address

61 Idlewood Rd
Wolcott, CT 06716
Phone (203) 879-4919

Other identifiers 1

IdentifierTypeStateIssuer
004101828MedicaidCT

Other names 1

  • Mrs. Terri Bebrin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000286 CT Practitioner - Optometry 2264419969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TLC Eye Care, LLCGroup PAC ID 6103985114, 2 clinicians

Practice addresses (Care Compare)

930 N Colony Rd
Suite I
Wallingford, CT 06492-2471
Phone (203) 265-4362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Eye Care, LLC Optometrist CurrentSince Sep 1, 2012 Accepting new patients
Colony Opticians Optometrist Past Accepting new patients

Locations

930 N Colony Rd
Ste I
Wallingford, CT 06492
Phone (203) 265-4362

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1003022377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 IDLEWOOD RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "06716",
            "telephone_number": "203-879-4919",
            "fax_number": "203-265-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N COLONY RD",
            "address_2": "SUITE I",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922471",
            "telephone_number": "203-265-4362",
            "fax_number": "203-265-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYR",
        "first_name": "TERRI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DR OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004101828",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "BEBRIN",
            "prefix": "MRS.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.