Individual provider Active NPI

Alyssa Chrisman, O.D.

  • Optometrist
  • Farmington, CT
National Provider Identifier
1487278479
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003220 Issued in CT
Practice address
1600 S East Rd Ste 7
Farmington, CT 06032
Phone
(860) 507-0624
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3638-05 WI
Optometrist 152W00000X 003220 CT Primary

Addresses

Primary practice location

1600 S East Rd Ste 7
Farmington, CT 06032

Mailing address

1600 S East Rd Ste 7
Farmington, CT 06032-2608
Phone (860) 507-0624

Other practice location 1

2910 Roosevelt Rd # D1
Marinette, WI 54143-5108
Phone (715) 735-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200921000312 WI Practitioner - Optometry 7416375654 Reassigns benefits to 1 organization
I20210113001980 VA Practitioner - Optometry 7416375654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

2360 Costco Way
Suite 120
Green Bay, WI 54311-9210
Phone (920) 468-4642

6000 Monona Dr
Suite 101
Monona, WI 53716-3329
Phone (608) 222-9420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3638-05WIMDOptometrist
003220CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jan 11, 2021 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jan 11, 2021 Accepting new patients
National Vision Inc Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince Jan 2, 2024 Accepting new patients

Locations

1600 S East Rd
Ste 7
Farmington, CT 06032
Phone (860) 507-0624

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

1328 Greenbrier Pkwy
Ste 420
Chesapeake, VA 23320
Phone (757) 523-2000

1401 Greenbrier Pkwy
Ste 1150
Chesapeake, VA 23320
Phone (757) 523-2000

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

3525 E Calumet St
Ste 1400
Appleton, WI 54915
Phone (920) 788-4114

2621 S Oneida St
Ste 104
Green Bay, WI 54304
Phone (920) 499-3511

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1487278479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S EAST RD STE 7",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322608",
            "telephone_number": "860-507-0624",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S EAST RD STE 7",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-507-0624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2910 Roosevelt Rd # D1",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541435108",
            "country_code": "US",
            "telephone_number": "715-735-0260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISMAN",
        "first_name": "ALYSSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3638-05",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "003220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.