Active NPI
Robert P Mingrone, O.D.
- Optometrist
- West Haven, CT
National Provider Identifier
1275568701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 000905
- Practice address
- 153 Saw Mill Rd
West Haven, CT 06516-4100 - Phone
- (203) 934-1400
- Fax
- (203) 933-6817
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 000905 | CT | Primary |
Addresses
Primary practice location
153 Saw Mill Rd
West Haven, CT 06516-4100
Mailing address
153 Saw Mill Rd
West Haven, CT 06516-4100
Phone (203) 934-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004024782 | Medicaid | CT |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090120000059 | CT | Practitioner - Optometry | 9032272935 | Practice locations: Shelton, CT; West Haven, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
153 Saw Mill Rd
West Haven, CT 06516-4100
Phone (203) 934-1400
153 Sawmill Rd
West Haven, CT 06516-4100
28 Huntington PLZ
Shelton, CT 06484-5211
Phone (203) 925-8515
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905 | CT | MD | Behavioral Analyst |
| 000905 | CT | MD | Surgical Physician Assistant |
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, 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": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230508800000",
"number": "1275568701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 SAW MILL RD",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065164100",
"telephone_number": "203-934-1400",
"fax_number": "203-933-6817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 SAW MILL RD",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065164100",
"telephone_number": "203-934-1400",
"fax_number": "203-933-6817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINGRONE",
"first_name": "ROBERT",
"middle_name": "P",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2008-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "000905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004024782",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.