NPIMap

Organization Active NPI

Kallinen Eye Care, LLC

  • Optometrist
  • Groton, CT
National Provider Identifier
1114582129
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KALLINEN EYE CARE, LLC
Practice address
1041 Poquonnock Rd
Groton, CT 06340-4211
Phone
(860) 445-1000
NPI assigned
May 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Mr. Marc B Kallinen, ODNPI 1184056640
Title
Owner
Phone
(860) 445-1000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1041 Poquonnock Rd
Groton, CT 06340-4211

Mailing address

1041 Poquonnock Rd
Groton, CT 06340-4211
Phone (860) 445-1000

Other names 1

  • Groton Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191016003097 CT Part B Supplier - Clinic/Group Practice 3779814181 Receives reassigned benefits from 4 practitioners
Practice locations: Groton, CT

National Provider Directory

National Provider Directory

Locations

1041 Poquonnock Rd
Ste A
Groton, CT 06340
Phone (860) 445-1000

1041 Poquonnock Rd
Groton, CT 06340
Phone (860) 373-4148

1041 Poquonnock Rd
Ste 0
Groton, CT 06340

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1114582129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404211",
            "telephone_number": "860-445-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404211",
            "telephone_number": "860-445-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALLINEN EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "KALLINEN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-445-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Groton Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Groton Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.