Myeyedr Optometry of Connecticut, LLC
Organization Active NPI Optometrist · Manchester, CT
NPI 1467048710 · NPPES record last updated May 23, 2022
Key facts
- NPI
- 1467048710
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- MYEYEDR OPTOMETRY OF CONNECTICUT, LLC
- Practice address
- 29 Buckland St
Manchester, CT 06042-1601 - Phone
- (860) 646-6655
- Fax
- (860) 647-7872
- NPI assigned
- Dec 21, 2020
- Organization subpart
- No
Authorized official
- Name
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Other NPIs on the same Medicare enrollment 33
Other NPIs with the same Medicare PAC ID 7
Practitioners 72
-
Barbara Dune, O.D.
-
Nicholas Motto, O.D.
-
Aylin Adem, OD
-
Amara Akbar, OD
-
Mara S Capuano, O.D.
-
Richard J Colo, OD
-
Monique L Dawson, O.D.
-
Marc Denigris, O.D.
-
Janine R Elder, O.D.
-
Judith F Elson, OD
-
Susan Evans, OD
-
Catherine M. Ferentini, O.D.
-
William Joseph Filchak, O.D.
-
Stacey A Flynt, OD
-
Roseann Guglielmo, O.D.
-
Dean R Harvey, OD
-
Rachel Lyn Hawran, O.D.
-
Iva Hoxha, OD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2301976 | Myeyedr Optometry of Connecticut, LLC | Certificate of waiver | Apr 2, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160217001075 | CT | Part B Supplier - Clinic/Group Practice | 1557666237 |
Receives reassigned benefits from 126 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Norwalk, CT; Orange, CT; Ridgefield, CT; Rocky Hill, CT; Shelton, CT; South Windsor, CT; Southbury, CT; Suffield, CT… |
| O20230330000033 | CT | DME Supplier - Physician - Optometrist | 1557666237 | Practice locations: Manchester, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
29 Buckland St
Manchester, CT 06042-1601
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names
- MyEyeDr.
Other providers in Manchester, CT
- Judy Murray
- Amy Hogan Musco
- Evelyn Musserenden
- Edith Mwenelupembe
- Jonathan Myette
- Sriram V Myneni
- Kristen L Myshrall
- Jennifer Marie Wilson Nadeau
- Natalie Nicole Nadeau
- Madhura Naik
All providers in Manchester, CT · Optometrist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.