Xiaomin Fang, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2864 Issued in CT

Practice address

180 River Rd
Wal-Mart Vision Center
Lisbon, CT 06351-3249

Phone

(781) 330-2605

NPI assigned

Sep 20, 2012

Last updated

Sep 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Westfarms Eye Associates PC

  • Optometrist
  • Farmington, CT
  • NPI 1568520773
  NPD

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1265783047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 REGAN RD",
            "address_2": "APT. 26C",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662850",
            "telephone_number": "781-330-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 RIVER RD",
            "address_2": "WAL-MART VISION CENTER",
            "city": "LISBON",
            "state": "CT",
            "postal_code": "063513249",
            "telephone_number": "781-330-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "XIAOMIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Sandra Debrady, CADC, MSW
• Katryna Rae Deogburn, RD
• Mark David Deponte, MD
• Eastern Connecticut Rehabilitation Centers (Ecrc)
• Eastern Connecticut Rehabilitation Centers
• Jeigh Hayes, LPC
• Jennifer Holcomb
• Richard Homer, DMD
• Melanie I Hopkins, PA-C
• Corrie Sandra Hoyt, MA OF SCIENCE OF OT

• Optometrist in Lisbon, CT
• Providers in Lisbon, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.