Individual provider Active NPI

Eric L Wasserman, M.D.

  • Ophthalmology Physician
  • Stamford, CT
National Provider Identifier
1023016011
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
028681 Issued in CT
Practice address
1275 Summer St
Suite 200
Stamford, CT 06905-5359
Phone
(203) 978-0800
Fax
(203) 674-8519
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 028681 CT Primary

Addresses

Primary practice location

1275 Summer St
Suite 200
Stamford, CT 06905-5359

Mailing address

1275 Summer St
Suite 200
Stamford, CT 06905-5359
Phone (203) 978-0800

Other identifiers 1

IdentifierTypeStateIssuer
180000379OtherCTPTAN

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080422000710 CT Practitioner - Ophthalmology 0840378493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York Medical College, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1275 Summer St
Suite 200
Stamford, CT 06905-5315
Phone (203) 978-0800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.6 of 100Reported as individual
Quality
51.21
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
028681CTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Center of Stamford, LLC Ophthalmology CurrentSince Jan 10, 1989 Accepting new patients
The Eyeglass Store Past Accepting new patients

Locations

1275 Summer St
Stamford, CT 06905
Phone (203) 353-9099

1275 Summer St
Ste 200
Stamford, CT 06905
Phone (203) 978-0800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1023016011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "address_2": "SUITE 200",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-978-0800",
            "fax_number": "203-674-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SUMMER ST",
            "address_2": "SUITE 200",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055359",
            "telephone_number": "203-978-0800",
            "fax_number": "203-674-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "ERIC",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "028681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "180000379",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.