Organization Active NPI

Greene Eye Care LLC

  • Optometrist
  • Cromwell, CT
National Provider Identifier
1174068357
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GREENE EYE CARE LLC
Practice address
160 West St
Cromwell, CT 06416-2440
Phone
(860) 635-6149
Fax
(860) 632-1401
NPI assigned
Dec 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Todd Greene, ODNPI 1275535544
Title
Authorized Rep/Owner
Phone
(860) 635-6149

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 CT Primary

Addresses

Primary practice location

160 West St
Cromwell, CT 06416-2440

Mailing address

160 West St
Cromwell, CT 06416-2440
Phone (860) 635-6149

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170202001105 CT Part B Supplier - Clinic/Group Practice 4688957467 Receives reassigned benefits from 1 practitioner
Practice locations: Cromwell, CT

National Provider Directory

National Provider Directory

Locations

160 West St
Ste J
Cromwell, CT 06416
Phone (860) 635-6149

Practitioners & affiliated clinicians

Practitioners 1

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": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1174068357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WEST ST",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162440",
            "telephone_number": "860-635-6149",
            "fax_number": "860-632-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WEST ST",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162440",
            "telephone_number": "860-635-6149",
            "fax_number": "860-632-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "AUTHORIZED REP/OWNER",
        "authorized_official_telephone_number": "860-635-6149",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.