Individual provider Active NPI

Stewart Edward Galeucia, OD

  • Optometrist
  • Groton, CT
National Provider Identifier
1265414114
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002803 Issued in CT
Practice address
150 Gold Star Hwy
Groton, CT 06340-3442
Phone
(860) 448-2022
Fax
(508) 484-2008
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 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 002803 CT Primary

Addresses

Primary practice location

150 Gold Star Hwy
Groton, CT 06340-3442

Mailing address

85 River Rd
Apt K2
Essex, CT 06426-1345
Phone (860) 215-0256

Other identifiers 1

IdentifierTypeStateIssuer
0348023MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002803CTMDPhysician Assistant
2979MAMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Hopkinton Eye Associates Inc Optometrist PastSince May 1, 1997 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1265414114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 RIVER RD",
            "address_2": "APT K2",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261345",
            "telephone_number": "860-215-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403442",
            "telephone_number": "860-448-2022",
            "fax_number": "508-484-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALEUCIA",
        "first_name": "STEWART",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348023",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.