Erica A. Nierendorf, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0965 Issued in CT

Practice address

72 Farmington Ave
Bristol, CT 06010-4216

Phone

(860) 314-2949

Fax

(860) 314-2951

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica N. Petitti Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Envision 2020 Eyecare, LLC

  • Optometrist
  • Avon, CT
  • NPI 1801445028
  Medicare reassignment NPD
• Oculusdocs, LLC

  • Optometrist
  • Glastonbury, CT
  • NPI 1407490055
  Medicare reassignment

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1376750786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013690",
            "telephone_number": "860-409-4565",
            "fax_number": "860-409-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104216",
            "telephone_number": "860-314-2949",
            "fax_number": "860-314-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERENDORF",
        "first_name": "ERICA",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "965",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "0965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "PETITTI",
            "middle_name": "N.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Josephine Nguyen
• Ryan Nguyen
• Trung Quoc Nguyen, DDS
• Sharon Nicoll, OTA
• Nienna Counseling PLLC
• North Main Dental Group LLC
• Northeast Hearing LLC
• Cassie Nowak, LMFT
• Maria R O'Brien, MD
• Riley Anne O'Hanlon

• Optometrist in Bristol, CT
• Providers in Bristol, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.