Premier Eyecare

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

000994 Issued in CT

Legal business name

PREMIER EYECARE

Practice address

35 Pleasant Street 2C
Meriden, CT 06450

Phone

(203) 235-4462

Fax

(203) 238-4436

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John BiestekNPI 1174524896

Title

Owner

Phone

(203) 235-4462

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

Practitioners 2

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

• John Biestek, O.D.

  • Optometrist
  • Meriden, CT
  • NPI 1174524896
  NPD (past) Authorized official
• Michael James Shiembob, OD

  • Optometrist
  • Avon, CT
  • NPI 1225087000
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1033376330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PLEASANT ST STE 2C",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507596",
            "telephone_number": "203-235-4462",
            "fax_number": "203-238-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PLEASANT STREET 2C",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-235-4462",
            "fax_number": "203-238-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "BIESTEK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-235-4462",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CT",
            "license": "000994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "117606",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3624859",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V1922",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "000994",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2204200",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "505654",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004053278",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "702660",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH NETWORK",
            "identifier": "906424",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "090000994CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Albert Potter III, LCSW
• Aimee L. Powers, PT
• Anca M Pralea, M.D.
• Lisa M Pranger
• Premier Dental P C
• Premier Eyecare of Meriden LLC.
• James Price
• Laura Prior, APRN
• Diane H Puppolo, APRN
• Puranik Family Medical Center LLC

• Exclusive Provider Organization in Meriden, CT
• Providers in Meriden, CT by specialty
• Exclusive Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.