Active NPI
Opticare Eye Health Centers, Inc.
- Optometrist
- Waterbury, CT
National Provider Identifier
1497705677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Ophthalmology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004171766 | Medicaid | CT | |
| 004002812 | Medicaid | CT | |
| 004081353 | Medicaid | CT |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Optometrist
- New Haven, CT
- NPI 1548211220
-
- Ophthalmology Physician
- New York, NY
- NPI 1679535314
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.