Individual provider Active NPI

Maha Ramamurthy, O.D., M.S.

  • Optometrist
  • Wethersfield, CT
National Provider Identifier
1154492718
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2672 Issued in CT
Practice address
67 Wells Rd
Wethersfield, CT 06109-3043
Phone
(860) 529-5429
Fax
(860) 563-5202
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CT2672 CT
Corneal and Contact Management Optometrist 152WC0802X 2672 CT
Low Vision Rehabilitation Optometrist 152WL0500X 2672 CT
Pediatric Optometrist 152WP0200X 2672 CT
Sports Vision Optometrist 152WS0006X 2672 CT
Vision Therapy Optometrist 152WV0400X 2672 CT
Optometrist 152W00000X 2672 CT Primary

Addresses

Primary practice location

67 Wells Rd
Wethersfield, CT 06109-3043

Mailing address

67 Wells Rd
Wethersfield, CT 06109-3043
Phone (860) 529-5429

Other practice location 1

140 Kane St
Unit A2
West Hartford, CT 06119-2197
Phone (860) 231-9091

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
I20050810000102 CT Practitioner - Optometry 7719916766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

67 Wells Rd
Wethersfield, CT 06109-3043
Phone (860) 529-5429

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CT2672CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Advanced Eyecare LLC Optometrist CurrentSince Jan 26, 2010 Accepting new patients
Jerome Glazer OD Optometrist PastSince Jan 26, 2010 Accepting new patients

Locations

67 Wells Rd
Wethersfield, CT 06109
Phone (860) 529-5429

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154492718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-529-5429",
            "fax_number": "860-563-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-529-5429",
            "fax_number": "860-563-5202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Kane St",
            "address_2": "Unit A2",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061192197",
            "country_code": "US",
            "telephone_number": "860-231-9091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMAMURTHY",
        "first_name": "MAHA",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2672",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CT",
            "license": "2672",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CT",
            "license": "2672",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CT",
            "license": "2672",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CT",
            "license": "2672",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CT",
            "license": "2672",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.