Northeast Ophthalmic Plastic and Reconstructive Surgeons PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

NORTHEAST OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGEONS PLLC

Practice address

1817 Black Rock Tpke
Fairfield, CT 06825-3515

Phone

(203) 424-0228

NPI assigned

Oct 29, 2021

Organization subpart

No

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

Authorized official

Name

Larissa Habib, MDNPI 1447525654

Title

Physician

Phone

(203) 424-0228

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25263/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larissa Ann Habib, MD

  • Ophthalmology Physician
  • Fairfield, CT
  • NPI 1447525654

  CT, Ophthalmology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1295499820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253515",
            "telephone_number": "203-424-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253515",
            "telephone_number": "203-424-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGEONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-29",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "HABIB",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "203-424-0228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008089624",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "neons.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1817 Black Rock Tpke",
            "city": "Fairfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068253515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "neons.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "1817 Black Rock Tpke",
            "city": "Fairfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068253515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Nocerino, DDS
• Julie Nolan
• Jennifer M Nori, PHYSICIAN ASSISTANT
• Northeast Medical Group, Inc
• Northeast Medical Group, Inc.
• Northeast Wellness Clinic PLLC
• Samantha Rae November, ATC, LAT
• Larry E. Novik, M.D.
• Novo Women'S Health, P.C.
• Sandra Nute-Aupi, PA

• Ophthalmology Physician in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.