NPIMap

Organization Active NPI

Dixwell Avenue Eyecare PLLC

  • Optometrist
  • Hamden, CT
National Provider Identifier
1033694179
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DIXWELL AVENUE EYECARE PLLC
Practice address
2100 Dixwell Ave Ste 16
Hamden, CT 06514-2406
Phone
(203) 281-4330
Fax
(203) 288-4018
NPI assigned
Sep 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Dr. Stephen M Carr, OD
Title
Manager
Phone
(203) 767-9169

Specialties & licenses 1

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

Addresses

Primary practice location

2100 Dixwell Ave Ste 16
Hamden, CT 06514-2406

Mailing address

531 Fairfield Beach Rd
Fairfield, CT 06824-6740
Phone (203) 767-9169

Other identifiers 1

IdentifierTypeStateIssuer
008036359MedicaidCT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1033694179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 FAIRFIELD BEACH RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246740",
            "telephone_number": "203-767-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DIXWELL AVE STE 16",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142406",
            "telephone_number": "203-281-4330",
            "fax_number": "203-288-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXWELL AVENUE EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-767-9169",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008036359",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.