Individual provider Active NPI

Andrew Scott Maxwell, OD

  • Optometrist
  • Enfield, CT
National Provider Identifier
1578453320
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3405 Issued in CT
Practice address
149 Hazard Ave # 4521
Enfield, CT 06082-4521
Phone
(860) 749-0757
Fax
(860) 763-4335
NPI assigned
Jul 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3405 CT Primary

Addresses

Primary practice location

149 Hazard Ave # 4521
Enfield, CT 06082-4521

Mailing address

8 Wilson CT
Enfield, CT 06082-5225
Phone (860) 805-2248

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250806002490 CT Practitioner - Optometry 3971011222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enfield Eyecare Associates LLPGroup PAC ID 9537121488, 4 clinicians

Practice addresses (Care Compare)

149 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 749-0757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003405CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enfield Eyecare Associates, L.L.P. Optometrist CurrentSince Jul 29, 2025 Accepting new patients
Richard a Fichman MD PC PastSince Jul 29, 2025 Accepting new patients

Locations

149 Hazard Ave
Enfield, CT 06082
Phone (860) 649-9973

149 Hazard Ave
#4521
Enfield, CT 06082
Phone (860) 749-0757

Organizations & group practices 2

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": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1578453320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILSON CT",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825225",
            "telephone_number": "860-805-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HAZARD AVE # 4521",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-749-0757",
            "fax_number": "860-763-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "ANDREW",
        "middle_name": "SCOTT",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.