Tribury Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TRIBURY EYE CARE

Practice address

175 Main St S Ste 2
Woodbury, CT 06798-3448

Phone

(215) 805-4299

NPI assigned

Dec 15, 2021

Last updated

Dec 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tara Baideme, O.D.NPI 1588729701

Title

Optometrist

Phone

(215) 805-4299

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Baideme, OD

  • Optometrist
  • Bluffton, SC
  • NPI 1588729701

  CT

  Medicare reassignment Care Compare group NPD Authorized official
• Michael John Berzansky, OD

  • Optometrist
  • Woodbury, CT
  • NPI 1164562682
  Medicare reassignment Care Compare group NPD
• Kenneth L Burke, OD

  • Optometrist
  • Woodbury, CT
  • NPI 1881608263
  NPD (past)

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1457010688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HIGHRIDGE RD UNIT 4",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067622946",
            "telephone_number": "215-805-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MAIN ST S STE 2",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983448",
            "telephone_number": "215-805-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIBURY EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "BAIDEME",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "215-805-4299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Foster Thompson, LPC
• Kimberly Reed Thompson, LCSW
• Samantha Jannette Tramuta, LCSW
• Tara Tranguch, ND
• Shannon Mae Traver, OTR/L
• Kaitlyn Nicole Tripodi, PA-C
• Mary Elsenboss Tyrrell, BS PHARM, PD
• Unalome Healing Center LLC
• Sandra Irene Valente, PH.D.,LADC, LPC, CCS
• David Vanhandel, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.