Active NPI
Lorraine J Fedyna, OD
- Optometrist
- Stratford, CT
National Provider Identifier
1316003775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1081
- Practice address
- 955 Ferry Blvd
Stratford, CT 06614-6094 - Phone
- (203) 375-7988
- Fax
- (203) 375-7989
- NPI assigned
- Dec 29, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1081 | CT | Primary |
Addresses
Primary practice location
955 Ferry Blvd
Stratford, CT 06614-6094
Mailing address
81 Main St
Southport, CT 06890-1322
Phone (203) 518-1014
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 |
|---|---|---|---|---|
| I20070524000658 | CT | Practitioner - Optometry | 7315044427 | Practice locations: Stratford, CT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1081 | CT | MD | Addiction (Substance Use Disorder) Counselor |
| 001081 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Sobel LLC | Optometrist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Optometrist
- Litchfield, CT
- NPI 1598950149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1316003775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 MAIN ST",
"city": "SOUTHPORT",
"state": "CT",
"postal_code": "068901322",
"telephone_number": "203-518-1014",
"fax_number": "860-417-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 FERRY BLVD",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066146094",
"telephone_number": "203-375-7988",
"fax_number": "203-375-7989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDYNA",
"first_name": "LORRAINE",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "1081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.