Michael Richard Sundman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002398 Issued in CT

Practice address

1400 Farmington Ave
Walmart Vision Center
Bristol, CT 06010-4701

Phone

(860) 585-1156

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063595783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 GILLETTE RD",
            "city": "NEW HARTFORD",
            "state": "CT",
            "postal_code": "060572809",
            "telephone_number": "860-496-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FARMINGTON AVE",
            "address_2": "WALMART VISION CENTER",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104701",
            "telephone_number": "860-585-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDMAN",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "020398",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "090002398CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Strickland, APRN
• Strides in Wellness LLC
• Jenna Sugar
• Jeanine Sullivan, LCSW
• Katherine Tilley Sullivan
• Robin Suplinskas, RN
• Surgical Associates of Bristol PC
• Geetha Rani Swamy Iyah, MD
• Chelsea Swanson, MS, CCC-SLP
• Megan Swenton

• Optometrist in Bristol, CT
• Providers in Bristol, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.