Individual provider Active NPI

Inna Lazar, OD

  • Optometrist
  • Old Greenwich, CT
National Provider Identifier
1255713079
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2947 Issued in CT
Practice address
13 Arcadia Rd Ste 18
Old Greenwich, CT 06870-1742
Phone
(203) 698-5049
Fax
(844) 364-2562
NPI assigned
Jun 29, 2015
Last updated
Jul 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2947 CT Primary

Addresses

Primary practice location

13 Arcadia Rd Ste 18
Old Greenwich, CT 06870-1742

Mailing address

13 Arcadia Road
Suite 18
Old Greenwich, CT 06611
Phone (203) 698-5049

Other identifiers 1

IdentifierTypeStateIssuer
1255713079MedicaidCT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151116000889 CT Practitioner - OptometryPractitioner - Ophthalmology 7012223712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OptometryAlso: Ophthalmology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenwich Eye Care CorpGroup PAC ID 1850666595, 3 clinicians
Proeye Care LLCGroup PAC ID 6406225648, 4 clinicians

Practice addresses (Care Compare)

13 Arcadia Rd
Suite 18
Old Greenwich, CT 06870-1742
Phone (203) 698-5049

36 Old Kings Hwy S
Suite 110
Darien, CT 06820-4523
Phone (203) 698-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2947CTMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Proeye Care LLC Optometrist CurrentSince Nov 16, 2022 Accepting new patients
Greenwich Eye Care Corp Optometrist CurrentSince Jun 12, 2017 Accepting new patients

Locations

36 Old Kings Hwy S
Ste 110
Darien, CT 06820
Phone (203) 202-9889

13 Arcadia Rd
Ste 18
Old Greenwich, CT 06870
Phone (203) 698-5049

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, 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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1255713079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ARCADIA ROAD",
            "address_2": "SUITE 18",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "06611",
            "telephone_number": "203-698-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ARCADIA RD STE 18",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701742",
            "telephone_number": "203-698-5049",
            "fax_number": "844-364-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "INNA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255713079",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Greenwich, CT

Sources for this page

Verify at the official NPI Registry.