Victor Paul, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3152 Issued in CT

Practice address

1920 Norwich New London Tpke
Uncasville, CT 06382-1384

Phone

(186) 084-8877

NPI assigned

Jun 17, 2020

Last updated

Jun 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 RI

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

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

I for an Eye, LLCGroup PAC ID 5991066714, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• I for an Eye, LLC

  dba DeCesare Eye Associates

  • Optometrist
  • Providence, RI
  • NPI 1376054445
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1295351104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PERKINS FARM DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554042",
            "telephone_number": "917-605-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 NORWICH NEW LONDON TPKE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821384",
            "telephone_number": "186-084-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orchard Grove Specialty Care Center LLC
• Nicole Eddy Ortiz, MSN, APRN, FNP-BC
• Carl Jay Ousley, SUBIDC
• Grace Park
• Nehaben Patel
• Yaohsien Peng, DDS
• Thomas C Peter, MD
• Calvin Phelan
• Ricky Phongsa
• Diana Plowell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.

Verify at the official NPI Registry.