Individual provider Active NPI

Kimberly A Ditolla, O.D.

  • Optometrist
  • Farmington, CT
National Provider Identifier
1194909572
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2481 Issued in CT
Practice address
499 Farmington Ave
Suite 100
Farmington, CT 06032-1943
Phone
(860) 678-0202
Fax
(860) 678-0224
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2481 CT Primary

Addresses

Primary practice location

499 Farmington Ave
Suite 100
Farmington, CT 06032-1943

Mailing address

499 Farmington Ave
Suite 100
Farmington, CT 06032-1943
Phone (860) 678-0202

Other identifiers 1

IdentifierTypeStateIssuer
004207347MedicaidCT

Other names 1

  • Kimberly Ditolla Partridge Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Direct@consultingophthalmologistsFarmingtonCT.Compulinkdirect.com

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
I20081203000865 CT Practitioner - Optometry 4284795691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consulting Ophthalmologists, P.C.Group PAC ID 5092700724, 12 clinicians

Practice addresses (Care Compare)

499 Farmington Ave
Farmington, CT 06032-1933
Phone (860) 678-0202

Merit-based Incentive Payment System (MIPS)

Final score
99.69 of 100Reported as group
Quality
99.38
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2481CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Consulting Ophthalmologists, PC Optometrist CurrentSince Jan 5, 2009 Accepting new patients
Consulting Ophthalmologists, P.C. CurrentSince Jan 5, 2009 Accepting new patients

Locations

499 Farmington Ave
Ste 100
Farmington, CT 06032
Phone (860) 678-0202

295 Western Blvd
Glastonbury, CT 06033
Phone (860) 678-0202

Interoperability endpoints

  • Direct secure messaging: direct@consultingophthalmologistsfarmingtonct.compulinkdirect.com

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": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1194909572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 FARMINGTON AVE",
            "address_2": "SUITE 100",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321943",
            "telephone_number": "860-678-0202",
            "fax_number": "860-678-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 FARMINGTON AVE",
            "address_2": "SUITE 100",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321943",
            "telephone_number": "860-678-0202",
            "fax_number": "860-678-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITOLLA",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004207347",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@consultingophthalmologistsFarmingtonCT.Compulinkdirect.com",
            "affiliation": "N",
            "address_1": "499 Farmington Ave",
            "address_2": "SUITE 100",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060321943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PARTRIDGE",
            "middle_name": "DITOLLA",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.