Brian Paul Courtemanche, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002567 Issued in CT

Practice address

230 N Main St
Manchester, CT 06042-2004

Phone

(860) 646-4083

Fax

(860) 647-1733

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoreline Eye Group PCGroup PAC ID 3971641002, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

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.

• Shoreline Eye Group PC

  • Ophthalmology Physician
  • Waterford, CT
  • NPI 1912111386
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1386673648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NORTH MAIN ST.",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422004",
            "telephone_number": "860-646-4083",
            "fax_number": "860-647-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422004",
            "telephone_number": "860-646-4083",
            "fax_number": "860-647-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTEMANCHE",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004218287",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410047532",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Corso
• Olivia Cosenza
• Marline Cosme, M.A. MFT
• Alfred Cotto
• Charlotte Couch, M.A.
• Mary G. Covello, MD
• Melissa Cowen, RN, BSN, MPH, CDE
• Albert Coy
• Laura Crane
• Carolyn R Crespi

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.