Individual provider Active NPI

Laura A Vodopivec, OD

  • Optometrist
  • N Windham, CT
National Provider Identifier
1336249366
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2496 Issued in CT
Practice address
494 Boston Post Rd
N Windham, CT 06256
Phone
(860) 423-5230
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2496 CT Primary

Addresses

Primary practice location

494 Boston Post Rd
N Windham, CT 06256

Mailing address

4 Chesterbrook LN
Andover, CT 06232-1037

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605001541 CT Practitioner - Optometry 5395194716 Practice locations: North Windham, CT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

474 Boston Post Rd
North Windham, CT 06256-1081
Phone (860) 423-5230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2496CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
New England Eyecare of Manchester, P.C. Optometrist Past Accepting new patients
New England Eyecare of Manchester, P.C. Optometrist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1336249366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHESTERBROOK LN",
            "city": "ANDOVER",
            "state": "CT",
            "postal_code": "062321037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 BOSTON POST RD",
            "city": "N WINDHAM",
            "state": "CT",
            "postal_code": "06256",
            "telephone_number": "860-423-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODOPIVEC",
        "first_name": "LAURA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.