Organization Active NPI

Look New Canaan LLC

  • Optometrist
  • New Canaan, CT
National Provider Identifier
1528749777
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LOOK NEW CANAAN LLC
Practice address
21 Forest St Ste 8
New Canaan, CT 06840-4766
Phone
(475) 558-6400
NPI assigned
Jul 31, 2023
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Gus Ellison
Title
Coo
Phone
(475) 558-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

21 Forest St Ste 8
New Canaan, CT 06840-4766

Mailing address

21 Forest St Ste 8
New Canaan, CT 06840-4766
Phone (475) 558-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231212001320 CT Part B Supplier - Clinic/Group Practice 4082063342 Receives reassigned benefits from 1 practitioner
Practice locations: New Canaan, CT

National Provider Directory

National Provider Directory

Locations

21 Forest St
Ste 8
New Canaan, CT 06840
Phone (475) 558-6400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1528749777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FOREST ST STE 8",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068404766",
            "telephone_number": "475-558-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FOREST ST STE 8",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068404766",
            "telephone_number": "475-558-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOK NEW CANAAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "GUS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "475-558-6400"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Canaan, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.