Norwich Ophthalmology Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

001058 Issued in CT

Legal business name

NORWICH OPHTHALMOLOGY OPTICAL

Doing business as

Eye Q Optical

Practice address

179 Flanders Rd
Niantic, CT 06357-1203

Phone

(860) 447-8664

Fax

(860) 443-2986

NPI assigned

Apr 2, 2009

Last updated

Feb 16, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

NORWICH OPHTHALMOLOGY OPTICALAs reported in NPPES

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

Authorized official

Name

Dr. Jeffrey A. Hertz, M.D.NPI 1881623486

Title

President

Phone

(860) 886-0161

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EYE Q OPTICAL Doing business as

Part of

Norwich Ophthalmology Optical

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Norwich Ophthalmology Optical

  dba Eye Q Optical

  • Eyewear Supplier
  • Norwich, CT
  • NPI 1427081199
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey A Hertz, MD

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1881623486
  Authorized official Same address or phone

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1326280512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 FLANDERS RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571203",
            "telephone_number": "860-447-8664",
            "fax_number": "860-443-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 FLANDERS RD",
            "city": "NIANTIC",
            "state": "CT",
            "postal_code": "063571203",
            "telephone_number": "860-447-8664",
            "fax_number": "860-443-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWICH OPHTHALMOLOGY OPTICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORWICH OPHTHALMOLOGY OPTICAL",
        "enumeration_date": "2009-04-02",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-886-0161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "001058",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "00562",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/SHIELD",
            "identifier": "100000433CT03",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002781",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE Q OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Niantic, CT
• Providers in Niantic, CT by specialty
• Eyewear Supplier in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.