Nicholas E. Wisniewski, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002700 Issued in CT

Practice address

715 Middletown Rd
Colchester, CT 06415-2236

Phone

(860) 531-3852

Fax

(860) 468-4235

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

New England College of Optometry, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Norwich Optometry LLCGroup PAC ID 7517358823, 2 clinicians

Westchester Eye CareGroup PAC ID 7214251255, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Norwich Optometry LLC

  • Optometrist
  • Norwich, CT
  • NPI 1386208288
  Medicare reassignment Care Compare group NPD Authorized official
• Westchester Eye Care

  • Optometrist
  • Colchester, CT
  • NPI 1427452473
  Medicare reassignment Care Compare group NPD Authorized official
• Wild Apple Eye III LLC

  • Optometrist
  • Hebron, CT
  • NPI 1346900412
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1124199864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MIDDLETOWN RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152236",
            "telephone_number": "860-531-3852",
            "fax_number": "860-468-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MIDDLETOWN RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152236",
            "telephone_number": "860-531-3852",
            "fax_number": "860-468-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "NICHOLAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Apple Eye II LLC
• Wildwood Wellness
• Charlene Ann Willax, RN
• Julie Danielle Willing, LCSW
• Kevin Neal Winicki, RPH
• Ellen Young
• Renee Young
• Martin H Zase, DMD
• Alice Teresa Zic, MPH, LCSW
• Rebecca Ziskind, LPC

• Optometrist in Colchester, CT
• Providers in Colchester, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.