Active NPI
Sarah Domek, LO
- Optician
- New Haven, CT
National Provider Identifier
1285147645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1757
- Practice address
- 315 Foxon Blvd
New Haven, CT 06513-2355 - Phone
- (203) 467-7509
- NPI assigned
- Nov 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1757 | CT | Primary |
| Ophthalmic Technician/Technologist | 156FX1100X | 1757 | CT |
Addresses
Primary practice location
315 Foxon Blvd
New Haven, CT 06513-2355
Mailing address
315 Foxon Blvd
New Haven, CT 06513-2355
Phone (203) 467-7632
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1757 | Medicaid | CT | |
| 1285147645 | Medicaid | CT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | s0d08tl.s05439@us.wal-mart.com | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1757 | CT | MD | Ophthalmic Technician/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1285147645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 FOXON BLVD",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065132355",
"telephone_number": "203-467-7632",
"fax_number": "203-468-6851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 FOXON BLVD",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065132355",
"telephone_number": "203-467-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMEK",
"first_name": "SARAH",
"credential": "LO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CT",
"license": "1757",
"primary": true
},
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": "CT",
"license": "1757",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1757",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1285147645",
"state": "CT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "s0d08tl.s05439@us.wal-mart.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "315 Foxon Blvd",
"city": "New Haven",
"state": "CT",
"country_code": "US",
"postal_code": "065132355",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.