Organization Active NPI

David W. Joel LLC

Doing business as David W. Joel

  • Optometrist
  • New Haven, CT
National Provider Identifier
1083186746
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DAVID W. JOEL LLC
Doing business as
David W. Joel
Practice address
130 Amity Rd
Family Eye Care Center
New Haven, CT 06515-1405
Phone
(203) 397-3878
Fax
(203) 397-9110
NPI assigned
Dec 19, 2018
Last updated
Feb 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Authorized official

Name
Dr. David W Joel, ODNPI 1861484081
Title
Owner
Phone
(203) 397-3878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Corneal and Contact Management Optometrist 152WC0802X

Addresses

Primary practice location

130 Amity Rd
Family Eye Care Center
New Haven, CT 06515-1405

Mailing address

130 Amity Rd
Family Eye Care Center
New Haven, CT 06515-1405
Phone (203) 397-3878

Other identifiers 1

IdentifierTypeStateIssuer
004101218MedicaidCT

Other names 1

  • David W. Joel Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200114002824 CT Part B Supplier - Clinic/Group Practice 6204261589 Receives reassigned benefits from 3 practitioners
Practice locations: New Haven, CT

National Provider Directory

National Provider Directory

Locations

130 Amity Rd
New Haven, CT 06515
Phone (203) 397-3878

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1083186746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 AMITY RD",
            "address_2": "FAMILY EYE CARE CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151405",
            "telephone_number": "203-397-3878",
            "fax_number": "203-397-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 AMITY RD",
            "address_2": "FAMILY EYE CARE CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151405",
            "telephone_number": "203-397-3878",
            "fax_number": "203-397-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W. JOEL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "JOEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-397-3878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004101218",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David W. Joel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.