Individual provider Active NPI

Wendy Kok, O.D.

  • Optometrist
  • New Haven, CT
National Provider Identifier
1376709303
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002753 Issued in CT
Practice address
1457 Whalley Ave
New Haven, CT 06515-1153
Phone
(203) 562-3937
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002753 CT Primary

Addresses

Primary practice location

1457 Whalley Ave
New Haven, CT 06515-1153

Mailing address

1125 Commonwealth Ave
Apt #31
Allston, MA 02134-3201
Phone (617) 276-5694

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
I20081112000630 CT Practitioner - Optometry 8123187663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002753CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Jan 14, 2017 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Jan 14, 2017 Accepting new patients

Locations

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

1457 Whalley Ave
New Haven, CT 06515
Phone (203) 387-3937

54 Park Lane Rd
New Milford, CT 06776
Phone (860) 354-0130

87 Grandview Ave
Ste B
Waterbury, CT 06708
Phone (203) 465-1424

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1376709303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 COMMONWEALTH AVE",
            "address_2": "APT #31",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343201",
            "telephone_number": "617-276-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 WHALLEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151153",
            "telephone_number": "203-562-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOK",
        "first_name": "WENDY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.