Individual provider Active NPI

Danielle Gurciullo, OD

  • Optometrist
  • Windsor, CT
National Provider Identifier
1205568144
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3257 Issued in CT
Practice address
186 Broad St
Windsor, CT 06095-2925
Phone
(860) 870-5822
Fax
(860) 687-1324
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3257 CT Primary

Addresses

Primary practice location

186 Broad St
Windsor, CT 06095-2925

Mailing address

186 Broad St
Windsor, CT 06095-2925
Phone (860) 870-5822

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
I20220913000481 CT Practitioner - Optometry 1355726316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelly Family Eyecare LLCGroup PAC ID 1951697598, 3 clinicians

Practice addresses (Care Compare)

458 Talcottville Rd
Suite 1
Vernon, CT 06066-4052
Phone (860) 870-5822

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Family Eyecare, LLC Optometrist CurrentSince May 1, 2025 Accepting new patients
Wallingford Eye Care Center P.C. Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Wayne M. Levasseur, O.D. PastSince May 1, 2025 Accepting new patients

Locations

458 Talcottville Rd
Vernon Rockville, CT 06066
Phone (860) 875-4314

458 Talcottville Rd
Ste 1
Vernon Rockville, CT 06066
Phone 5123086342516

821 N Main Street Ext
Wallingford, CT 06492
Phone (203) 265-5152

186 Broad St
Windsor, CT 06095
Phone (860) 688-1630

Organizations & group practices 3

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1205568144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 BROAD ST",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952925",
            "telephone_number": "860-870-5822",
            "fax_number": "860-687-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 BROAD ST",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952925",
            "telephone_number": "860-870-5822",
            "fax_number": "860-687-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURCIULLO",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.