Individual provider Active NPI

Irene Nasaduke, M.D.

  • Ophthalmology Physician
  • Stamford, CT
National Provider Identifier
1114055217
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
028817 Issued in CT
Practice address
1150 Summer Street
Stamford, CT 06905-5530
Phone
(203) 357-0770
NPI assigned
Mar 1, 2007
Last updated
Oct 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 028817 CT Primary
General Practice Physician 208D00000X 028817 CT

Addresses

Primary practice location

1150 Summer Street
Stamford, CT 06905-5530

Mailing address

1150 Summer Street
Stamford, CT 06905-5530
Phone (203) 357-0770

Other identifiers 2

IdentifierTypeStateIssuer
0100Z8817C701OtherANTHEM
001288176MedicaidCT

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000391 CT Practitioner - OphthalmologyPractitioner - General Practice 5991856353 Practice locations: Stamford, CT

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: General Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1150 Summer St
Stamford, CT 06905-5530
Phone (203) 357-0770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
028817CTMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1114055217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 SUMMER STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055530",
            "telephone_number": "203-357-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 SUMMER STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055530",
            "telephone_number": "203-357-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASADUKE",
        "first_name": "IRENE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "028817",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CT",
            "license": "028817",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0100Z8817C701",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001288176",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.