NPIMap

Organization Active NPI

Ratchford Eye Center LLC

  • Ophthalmology Physician
  • Berlin, CT
National Provider Identifier
1003995077
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
037297 Issued in CT
Legal business name
RATCHFORD EYE CENTER LLC
Practice address
1166 Farmington Ave.
Berlin, CT 06037-2302
Phone
(860) 829-8939
Fax
(860) 829-8938
NPI assigned
Nov 2, 2006
Last updated
Dec 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Authorized official

Name
Mary Gina Ratchford, M.D.NPI 1578688909
Title
Member
Phone
(860) 829-8939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU
Ophthalmology Physician 207W00000X 037297 CT Primary

Addresses

Primary practice location

1166 Farmington Ave.
Berlin, CT 06037-2302

Mailing address

1166 Farmington Ave.
Berlin, CT 06037-2302
Phone (860) 829-8939

Other identifiers 1

IdentifierTypeStateIssuer
004259158MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060221000199 CT Part B Supplier - Clinic/Group Practice 0244245728 Receives reassigned benefits from 4 practitioners
Practice locations: Berlin, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ratchford Eye Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: bkjellen@ratchfordeye.intellechartdirect.net
  • Direct secure messaging: jjacquesgoodman@ratchfordeye.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702684800000",
    "number": "1003995077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 FARMINGTON AVE.",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372302",
            "telephone_number": "860-829-8939",
            "fax_number": "860-829-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 FARMINGTON AVE.",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372302",
            "telephone_number": "860-829-8939",
            "fax_number": "860-829-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RATCHFORD EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "RATCHFORD",
        "authorized_official_first_name": "MARY GINA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-829-8939",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "037297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004259158",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.