Individual provider Active NPI

Helen Ambizas, O.D.

  • Optometrist
  • Stratford, CT
National Provider Identifier
1376716860
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002738 Issued in CT
Practice address
775 Main St
Stratford, CT 06615-7406
Phone
(203) 377-2020
NPI assigned
Apr 7, 2008
Last updated
Apr 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002738 CT Primary
Optometrist 152W00000X 006085 NY

Addresses

Primary practice location

775 Main St
Stratford, CT 06615-7406

Mailing address

775 Main St
Stratford, CT 06615-7406
Phone (203) 377-2020

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
I20100201000620 CT Practitioner - Optometry 4183767023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Connecticut Professional PLLCGroup PAC ID 1658713797, 12 clinicians

Practice addresses (Care Compare)

107 Boston Ave
Bridgeport, CT 06610-1648
Phone (203) 307-5769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002738CTMDClinical Psychologist
006085NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Connecticut Professional PLLC Optometrist CurrentSince Oct 7, 2024 Accepting new patients
Philip M Perrino P.C. Optometrist Past Accepting new patients

Locations

107 Boston Ave
Bridgeport, CT 06610
Phone (203) 307-5769

815 Chapel St
New Haven, CT 06510
Phone (203) 644-0038

775 Main St
Stratford, CT 06615
Phone (203) 307-5769

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1376716860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157406",
            "telephone_number": "203-377-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157406",
            "telephone_number": "203-377-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBIZAS",
        "first_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002738",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

Verify at the official NPI Registry.