Individual provider Active NPI

Robert P Mingrone, O.D.

  • Optometrist
  • West Haven, CT
National Provider Identifier
1275568701
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
000905 Issued in CT
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

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
004024782MedicaidCT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
905CTMDBehavioral Analyst
000905CTMDSurgical 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

Verify at the official NPI Registry.