Individual provider Active NPI

Mitchel Boyd Strand, OD

  • Optometrist
  • Newington, CT
National Provider Identifier
1003830308
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02135 Issued in CT
Practice address
485 Willard Ave
Newington, CT 06111-2318
Phone
(860) 666-7053
Fax
(860) 666-7083
NPI assigned
Jul 27, 2006
Last updated
Jan 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02135 CT Primary

Addresses

Primary practice location

485 Willard Ave
Newington, CT 06111-2318

Mailing address

485 Willard Ave
Newington, CT 06111-2318
Phone (860) 666-7053

Other identifiers 1

IdentifierTypeStateIssuer
004087947MedicaidCT

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
I20110203000370 CT Practitioner - Optometry 6608875562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

485 Willard Ave
Newington, CT 06111-2376
Phone (860) 666-7053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02135CTMDOptometrist
002135CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Total Vision-Eye Health Center, LLC Optometrist CurrentSince Jan 9, 1997 Accepting new patients
Totalvision Eye Health Center LLC Optometrist CurrentSince Jun 15, 1989 Accepting new patients
Total Vision-Eye Health Center LLC Optometrist Current Accepting new patients
Total Vision-Eye Health Center LLC Optometrist Current Accepting new patients
I for an Eye, LLC Optometrist Past Accepting new patients

Locations

12 Coogan Blvd
Mystic, CT 06355
Phone (860) 415-9292

12 Coogan Blvd
Ste 203
Mystic, CT 06355

32A Fenn Rd
Newington, CT 06111
Phone (860) 666-7053

485 Willard Ave
Newington, CT 06111
Phone (860) 666-7053

485 Willard Ave
Ste C
Newington, CT 06111
Phone (860) 666-7053

1920 Norwich New London Tpke
Uncasville, CT 06382
Phone (860) 848-8777

1920 Norwich New London Tpke
Unit 8
Uncasville, CT 06382
Phone (860) 848-3388

1920 Norwich New London Tpke
Unit C8
Uncasville, CT 06382

2020 Norwich New London Tpke
Unit C8
Uncasville, CT 06382
Phone (860) 848-8777

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1003830308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112318",
            "telephone_number": "860-666-7053",
            "fax_number": "860-666-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112318",
            "telephone_number": "860-666-7053",
            "fax_number": "860-666-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAND",
        "first_name": "MITCHEL",
        "middle_name": "BOYD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "02135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004087947",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

Verify at the official NPI Registry.