Organization Active NPI

Eyeconic Vision Care LLC

  • Optometrist
  • Newington, CT
National Provider Identifier
1013525302
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECONIC VISION CARE LLC
Practice address
2311 Berlin Tpke
Newington, CT 06111-3206
Phone
(860) 667-0921
NPI assigned
Jul 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Dr. Brittany Jones, ODNPI 1912430836
Title
Optometrist/Owner
Phone
(518) 796-5039

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2311 Berlin Tpke
Newington, CT 06111-3206

Mailing address

2311 Berlin Tpke
Newington, CT 06111-3206
Phone (860) 667-0921

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210224001734 CT Part B Supplier - Clinic/Group Practice 6608281639 Receives reassigned benefits from 4 practitioners
Practice locations: Newington, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2217564Eyeconic Vision Care, LLC2311 Berlin Tpke, Newington, CT 06111Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

175 West Rd
Ste 16
Ellington, CT 06029

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1013525302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 BERLIN TPKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061113206",
            "telephone_number": "860-667-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 BERLIN TPKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061113206",
            "telephone_number": "860-667-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECONIC VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "518-796-5039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.