Organization Active NPI

Della Porta Eyecare, LLC

  • Optometrist
  • Bristol, CT
National Provider Identifier
1366948150
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DELLA PORTA EYECARE, LLC
Practice address
156 Farmington Ave
Bristol, CT 06010-4218
Phone
(860) 582-0702
Fax
(860) 314-0263
NPI assigned
Apr 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Authorized official

Name
Dr. Maria Della Porta, ODNPI 1699781419
Title
Optometrist/Manager
Phone
(860) 919-5321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

156 Farmington Ave
Bristol, CT 06010-4218

Mailing address

156 Farmington Ave
Bristol, CT 06010-4218
Phone (860) 582-0702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180711001604 CT Part B Supplier - Clinic/Group Practice 3779839477 Receives reassigned benefits from 1 practitioner
Practice locations: Bristol, CT

National Provider Directory

National Provider Directory

Locations

271 Farmington Ave
Bristol, CT 06010
Phone (860) 582-0702

156 Farmington Ave
Bristol, CT 06010
Phone (860) 582-0702

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20933/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640304000000",
    "number": "1366948150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104218",
            "telephone_number": "860-582-0702",
            "fax_number": "860-314-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104218",
            "telephone_number": "860-582-0702",
            "fax_number": "860-314-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELLA PORTA EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A",
        "authorized_official_last_name": "DELLA PORTA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OPTOMETRIST/MANAGER",
        "authorized_official_telephone_number": "860-919-5321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.