Individual provider Active NPI

Richard Russell Rock, OD

  • Optometrist
  • Vernon, CT
National Provider Identifier
1073652558
Registry record updated May 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CT0745 Issued in CT
Practice address
348 Hartford Tpke
Vernon, CT 06066-4747
Phone
(860) 870-5800
Fax
(860) 871-0579
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CT0745 CT Primary

Addresses

Primary practice location

348 Hartford Tpke
Vernon, CT 06066-4747

Mailing address

97 Irene Dr
Vernon, CT 06066-4005
Phone (860) 872-8717

Other identifiers 3

IdentifierTypeStateIssuer
448993OtherCTCONNETICARE
OXFORDOtherCTP2751756
2322856OtherCTAETNA

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
I20150619001997 CT Practitioner - Optometry 5799096582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000745CTMDRegistered Dietitian
CT0745CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visual Perceptions-Vernon, LLC Optometrist PastSince Jun 13, 2011 Accepting new patients

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431820800000",
    "number": "1073652558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 IRENE DR",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664005",
            "telephone_number": "860-872-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664747",
            "telephone_number": "860-870-5800",
            "fax_number": "860-871-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "RICHARD",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT0745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNETICARE",
            "identifier": "448993",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P2751756",
            "identifier": "OXFORD",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2322856",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.