Organization Active NPI

Opticare Eye Health Centers, Inc.

  • Optometrist
  • Waterbury, CT
National Provider Identifier
1497705677
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTICARE EYE HEALTH CENTERS, INC.
Practice address
87 Grandview Ave
Waterbury, CT 06708-2514
Phone
(203) 574-2020
Fax
(203) 596-2230
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Authorized official

Name
Nancy A Noll
Title
Exec Vice Pres
Phone
(203) 574-2020

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Ambulatory Surgical Clinic/Center 261QA1903X 0071 CT

Addresses

Primary practice location

87 Grandview Ave
Waterbury, CT 06708-2514

Mailing address

87 Grandview Ave
Waterbury, CT 06708-2514
Phone (203) 574-2020

Other identifiers 3

IdentifierTypeStateIssuer
004171766MedicaidCT
004002812MedicaidCT
004081353MedicaidCT

National Provider Directory

National Provider Directory

Locations

54 Park Lane Rd
New Milford, CT 06776
Phone (860) 354-0130

100 Main St S
Southbury, CT 06488
Phone (203) 262-4559

87 Grandview Ave
Ste A
Waterbury, CT 06708
Phone (203) 574-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1497705677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICARE EYE HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "NOLL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXEC VICE PRES",
        "authorized_official_telephone_number": "203-574-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CT",
            "license": "0071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004171766",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004002812",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004081353",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.