Individual provider Active NPI

Jennifer L Stroh, O.D.

  • Optometrist
  • Manchester, CT
National Provider Identifier
1053344879
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002357 Issued in CT
Practice address
178 Hartford Rd
Manchester, CT 06040-5986
Phone
(860) 649-9973
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002357 CT Primary

Addresses

Primary practice location

178 Hartford Rd
Manchester, CT 06040-5986

Mailing address

178 Hartford Rd
Manchester, CT 06040-5986
Phone (860) 649-9973

Other identifiers 8

IdentifierTypeStateIssuer
2576641OtherCTAETNA PROVIDER ID
004186567MedicaidCT
004216314MedicaidCT
410045541OtherCTRAILROAD MEDICARE PROV ID
OV9840OtherCTHEALTHNET PROVIDER ID
P2515982OtherCTOXFORD PROVIDER ID
090002357CT03OtherCTANTHEM PROVIDER ID
678214OtherCTCONNECTICARE PROVIDER ID

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
I20070411000495 CT Practitioner - Optometry 9638274152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert R Palozej OD, LLCGroup PAC ID 9931388493, 2 clinicians

Practice addresses (Care Compare)

19 Pinney St
Ellington, CT 06029-5835
Phone (860) 875-7336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2357CTMDProfessional Counselor
002357CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Robert R Palozej OD, LLC Optometrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

19 Pinney St
Ellington, CT 06029
Phone (860) 871-9295

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1053344879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405986",
            "telephone_number": "860-649-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 HARTFORD RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405986",
            "telephone_number": "860-649-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROH",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "2576641",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004186567",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004216314",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV ID",
            "identifier": "410045541",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER ID",
            "identifier": "OV9840",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "P2515982",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "090002357CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE PROVIDER ID",
            "identifier": "678214",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.