Individual provider Active NPI

Robert T Yarosh, OD

  • Optometrist
  • Manchester, CT
National Provider Identifier
1184613259
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0823 Issued in CT
Practice address
164 E Center St
Manchester, CT 06040-5241
Phone
(860) 649-2020
Fax
(860) 643-1252
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0823 CT Primary
Optometrist 152W00000X 2525 MA
Optometrist 152W00000X 330 NH

Addresses

Primary practice location

164 E Center St
Manchester, CT 06040-5241

Mailing address

164 E Center St
Manchester, CT 06040-5241
Phone (860) 649-2020

Other identifiers 1

IdentifierTypeStateIssuer
4051579MedicaidCT

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
I20111005000545 CT Practitioner - Optometry 6709058217 Practice locations: Manchester, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
330NHMDClinical Psychologist
0823CTMDOptometrist
2525MAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184613259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405241",
            "telephone_number": "860-649-2020",
            "fax_number": "860-643-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405241",
            "telephone_number": "860-649-2020",
            "fax_number": "860-643-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAROSH",
        "first_name": "ROBERT",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "0823",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2525",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "330",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4051579",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.