Amy Keopraseuth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-000395 Issued in CO

Practice address

997 Main St
Watertown, CT 06795-2914

Phone

(860) 274-7576

NPI assigned

May 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

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.

• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Ansonia, CT
  • NPI 1396119194
  Medicare reassignment NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Cheshire, CT
  • NPI 1669846465
  NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Vernon, CT
  • NPI 1992207468
  NPD
• Plainville Optometrics LLC

  • Optometrist
  • Plainville, CT
  • NPI 1659663615
  NPD (past)

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1265923247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "860-274-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 MAIN ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952914",
            "telephone_number": "860-274-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOPRASEUTH",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3.003229",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT-000395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Juliano, MSPT
• Brynn Kallstrom
• Kimberly Keegan
• Megan K Kellogg, MA, MT-BC
• Kyle Brian Kemp, DPT
• Lisa Keys, PA-C
• Kevin Charles King, APRN
• Kerri Lynn Kozak, DPT
• Vangjelis Kristollari, PHARMD
• Cathy Kulmann, BCBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.