Individual provider Active NPI

Steven M Rapoport, OD

  • Optometrist
  • Waterford, CT
National Provider Identifier
1013017888
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
00857 Issued in CT
Practice address
25 Rope Ferry Rd
Waterford, CT 06385-2806
Phone
(860) 442-5012
Fax
(860) 442-2908
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00857 CT Primary

Addresses

Primary practice location

25 Rope Ferry Rd
Waterford, CT 06385-2806

Mailing address

25 Rope Ferry Rd
Waterford, CT 06385-2806
Phone (860) 442-5012

Other identifiers 1

IdentifierTypeStateIssuer
4024683MedicaidCT

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
I20120125000362 CT Practitioner - Optometry 1759400534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 Rope Ferry Rd
Waterford, CT 06385-2843
Phone (860) 442-5012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000857CTMDProfessional Counselor
00857CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven M. Rapoport O.D., LLC Optometrist CurrentSince Oct 10, 1986 Accepting new patients

Locations

25 Rope Ferry Rd
Waterford, CT 06385
Phone (860) 442-5012

Organizations & group practices 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013017888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROPE FERRY RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852806",
            "telephone_number": "860-442-5012",
            "fax_number": "860-442-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROPE FERRY RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852806",
            "telephone_number": "860-442-5012",
            "fax_number": "860-442-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPOPORT",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "00857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4024683",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

Verify at the official NPI Registry.