Active NPI
Richard D Molk, MD
- Ophthalmology Physician
- Glastonbury, CT
National Provider Identifier
1205800836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 25835
- Practice address
- 257 New London Tpke
Glastonbury, CT 06033-2232 - Phone
- (860) 659-4091
- Fax
- (860) 659-5752
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 25835 | CT | Primary |
Addresses
Primary practice location
257 New London Tpke
Glastonbury, CT 06033-2232
Mailing address
257 New London Tpke
Glastonbury, CT 06033-2232
Phone (860) 659-4091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1258359 | Medicaid | CT |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050214000443 | CT | Practitioner - Ophthalmology | 2567414022 | Practice locations: Glastonbury, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- New York Medical College, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
257 New London TNPK
Glastonbury, CT 06033
Phone (860) 659-4091
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 19 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25835 | CT | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1205800836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332232",
"telephone_number": "860-659-4091",
"fax_number": "860-659-5752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 NEW LONDON TPKE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332232",
"telephone_number": "860-659-4091",
"fax_number": "860-659-5752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLK",
"first_name": "RICHARD",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CT",
"license": "25835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1258359",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.