Mary Christine Beaulieu, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2212 Issued in CT

Practice address

131 Boston Post Rd
Suite 4
Waterford, CT 06385-2839

Phone

(860) 442-5058

Fax

(860) 443-4118

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Eyecare LLCGroup PAC ID 9133266679, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Professional Eyecare, LLC

  • Optometrist
  • Waterford, CT
  • NPI 1538396080
  Medicare reassignment Care Compare group NPD Authorized official
• Professional Opticians Inc

  • Optician
  • Waterford, CT
  • NPI 1063571214
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1528126117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 BOSTON POST RD",
            "address_2": "SUITE 4",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852839",
            "telephone_number": "860-442-5058",
            "fax_number": "860-443-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 BOSTON POST RD",
            "address_2": "SUITE 4",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852839",
            "telephone_number": "860-442-5058",
            "fax_number": "860-443-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004092277",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Jane Ballint, LCSW, LADC
• Gary Jules Bango
• Marjorie Wood Barndt, D.M.D., MDSC
• Jennifer Eve Bartholomew, PT
• Jessie R Baudner, ANP BC
• Josephine P Beebe, PHD
• Benjamin Beech, MD, FRCSC
• Joanna Bender, OTR/L
• Daniel Edmond Bendor, M.D.
• Mary Ann Dionne Bentz

• Optometrist in Waterford, CT
• Providers in Waterford, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.