Individual provider Active NPI

Jennie Leonard Maher, OD

  • Optometrist
  • Waterbury, CT
National Provider Identifier
1093533556
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3371 Issued in CT
Practice address
1320 W Main St Ste 3
Waterbury, CT 06708-3129
Phone
(203) 755-4941
NPI assigned
Oct 2, 2024
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 3371 CT Primary

Addresses

Primary practice location

1320 W Main St Ste 3
Waterbury, CT 06708-3129

Mailing address

1320 W Main St Ste 3
Waterbury, CT 06708-3129
Phone (203) 577-9202

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
I20241126001002 CT Practitioner - Optometry 0042745184 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Villacis Eyecare LLCGroup PAC ID 3577895028, 4 clinicians
Villacis Eyecare III, LLCGroup PAC ID 3274931688, 3 clinicians
Villacis Eye Care II, LLCGroup PAC ID 4789012444, 4 clinicians

Practice addresses (Care Compare)

1320 W Main St
Suite 3
Waterbury, CT 06708-3119
Phone (203) 755-4941

1449 Old Waterbury Rd
Unit 304
Southbury, CT 06488-3926
Phone (203) 267-2020

67 Waterbury Rd
Prospect, CT 06712-1218
Phone (203) 758-4447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Villacis Eyecare LLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Villacis Eyecare III, LLC Optometrist CurrentSince Aug 1, 2025 Accepting new patients
Villacis Eye Care II, LLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Villacis Eyecare IV, LLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients

Locations

20 Waterside Dr
Ste 102
Farmington, CT 06032
Phone (860) 674-0307

67 Waterbury Rd
Prospect, CT 06712
Phone (203) 758-4447

1449 Old Waterbury Rd
Unit 304
Southbury, CT 06488
Phone (203) 267-2020

1320 W Main St
Ste 3
Waterbury, CT 06708
Phone (203) 755-4941

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1093533556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST STE 3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083129",
            "telephone_number": "203-577-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST STE 3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083129",
            "telephone_number": "203-755-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "JENNIE",
        "middle_name": "LEONARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.