Olga Konykhov, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

46287 Issued in CT

Practice address

87 Grandview Ave
Waterbury, CT 06708-2514

Phone

(203) 574-2020

Fax

(203) 596-2230

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Group of Connecticut, LLCGroup PAC ID 3779482260, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eye Group of Connecticut, LLC

  • Ophthalmology Physician
  • Bridgeport, CT
  • NPI 1992721146
  Medicare reassignment Care Compare group NPD
• Orthopaedic Specialty Group, P.C.

  • Orthopaedic Surgery Physician
  • Fairfield, CT
  • NPI 1558313767
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1649260845
  Care Compare affiliation
• Bridgeport Hospital

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1992910152
  Care Compare affiliation

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1245375880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONYKHOV",
        "first_name": "OLGA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "46287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245375880",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Katie Kochera, LMFT
• Brooke H Kokus, PA-C
• Saritha Kolli, DO
• Karalee Kolpak, LPC
• Anitha Kommareddy
• Elizabeth Korn, APRN, LMFT
• Mikail Jayden Koroma, MD
• Robert Scott Korwin, PH.D.
• Ashley Koskovich
• Pavel Kosover, OTR/L

• Ophthalmology Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.

Verify at the official NPI Registry.