Individual provider Active NPI

Yasmine Khan Qureshi, OD

  • Optometrist
  • Newington, CT
National Provider Identifier
1508548488
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3306 Issued in CT
Practice address
555 Willard Ave
Newington, CT 06111-2631
Phone
(860) 666-6951
Fax
(860) 667-6833
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3306 CT Primary

Addresses

Primary practice location

555 Willard Ave
Newington, CT 06111-2631

Mailing address

555 Willard Ave
Newington, CT 06111-2631
Phone (860) 666-6951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821001515 CT Practitioner - Optometry 6305384322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians, PLLC CurrentSince Jun 14, 2024 Accepting new patients
Starling Physicians PLLC CurrentSince Jun 14, 2024 Accepting new patients
Starling Physicians, PLLC Past Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

1345 Farmington Ave
Bristol, CT 06010
Phone (860) 585-0000

Organizations & group practices 3

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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1508548488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "860-666-6951",
            "fax_number": "860-667-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WILLARD AVE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112631",
            "telephone_number": "860-666-6951",
            "fax_number": "860-667-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "YASMINE",
        "middle_name": "KHAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

Verify at the official NPI Registry.