Individual provider Active NPI

Brian Aurel Godard, O.D.

  • Optometrist
  • West Hartford, CT
National Provider Identifier
1194955914
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002774 Issued in CT
Practice address
355 N Main St
West Hartford, CT 06117-2511
Phone
(860) 233-2668
NPI assigned
Jul 15, 2009
Last updated
Jul 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002774 CT Primary

Addresses

Primary practice location

355 N Main St
West Hartford, CT 06117-2511

Mailing address

30 Sterling Ridge CT
Cheshire, CT 06410-1362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191204000240 PA Practitioner - Optometry 7911126297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allentown Vision Center, PCGroup PAC ID 9032002977, 4 clinicians

Practice addresses (Care Compare)

740 W Hamilton St
Suite 110
Allentown, PA 18101-2428
Phone (610) 434-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002774CTMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allentown Vision Center, PC Optometrist CurrentSince Oct 2, 2019 Accepting new patients

Locations

740 W Hamilton St
Ste 100
Allentown, PA 18101
Phone (610) 434-1000

740 W Hamilton St
Ste 110
Allentown, PA 18101

939 W Hamilton St
Allentown, PA 18101
Phone (610) 434-1000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1194955914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 STERLING RIDGE CT",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172511",
            "telephone_number": "860-233-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODARD",
        "first_name": "BRIAN",
        "middle_name": "AUREL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.