NPIMap

Organization Active NPI

Raffaele Inc

Doing business as Pearle Vision Center

  • Eyewear Supplier
  • Hamden, CT
National Provider Identifier
1346365145
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
001532 Issued in CT
Legal business name
RAFFAELE INC
Doing business as
Pearle Vision Center
Practice address
2100 Dixwell Ave
Suite 16
Hamden, CT 06514
Phone
(203) 281-4330
Fax
(203) 288-4018
NPI assigned
Mar 20, 2007
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Mr. Yehuda Eddie Elias, LICENCED OPTICIANNPI 1427427012
Title
Owner
Phone
(203) 281-4330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 001532 CT Primary

Addresses

Primary practice location

2100 Dixwell Ave
Suite 16
Hamden, CT 06514

Mailing address

2100 Dixwell Avenue
Suite 16
Hamden, CT 06514
Phone (203) 281-4330

Other identifiers 3

IdentifierTypeStateIssuer
21119OtherCTAVESIS
100001532CT01OtherCTBLUE CROSS
102188OtherCTEYE MED

Other names 1

  • Pearle Vision Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220627000694 CT Part B Supplier - Clinic/Group Practice 9638290240 Receives reassigned benefits from 23 practitioners
Practice locations: Hamden, CT

National Provider Directory

National Provider Directory

Locations

2100 Dixwell Ave
Hamden, CT 06514
Phone (203) 230-8019

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1346365145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DIXWELL AVENUE",
            "address_2": "SUITE 16",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06514",
            "telephone_number": "203-281-4330",
            "fax_number": "203-288-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DIXWELL AVE",
            "address_2": "SUITE 16",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "06514",
            "telephone_number": "203-281-4330",
            "fax_number": "203-288-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFFAELE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_middle_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-281-4330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENCED OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "001532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "21119",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "100001532CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "102188",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.