Brian Henry Wolanin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2904 Issued in CT

Practice address

5065 Main St # 1140
Trumbull, CT 06611-4204

Phone

(203) 374-3211

Fax

(203) 374-9344

NPI assigned

Jul 10, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Ohio State University - College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gold Coast Eye Associates, LLCGroup PAC ID 4587019724, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gold Coast Eye Associates, LLC

  • Optometrist
  • Trumbull, CT
  • NPI 1891124616
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1619318367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 FAIRFIELD AVE APT 107",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044295",
            "telephone_number": "614-381-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5065 MAIN ST # 1140",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114204",
            "telephone_number": "203-374-3211",
            "fax_number": "203-374-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLANIN",
        "first_name": "BRIAN",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1773",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Williamson, LMFT
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• Wings of Eagles Care Solutions LLC
• Krista Elizabeth Wise, APRN
• David H Witt, M.D.
• Anne Wolf, P.T.
• Carrie Beth Wolf, CNM
• Women'S Health Care, LLC
• Women'S Obstetrics and Gynecology, P.C.
• Brian John Wooley, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.