Mark Francis Di Loreto, O.D.
Individual provider Active NPI Optometrist · Kensington, CT
NPI 1629209150 · NPPES record last updated Sep 13, 2022
Key facts
- NPI
- 1629209150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 002773 (CT)
- Practice address
- 359 Main St
Kensington, CT 06037-2651 - Phone
- (860) 829-1020
- Fax
- (860) 828-5246
- NPI assigned
- Jul 31, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130410000380 | CT | Practitioner - Optometry | 0547406928 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002773 | CT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Mark Diloreto LLC | Optometrist | Current |
Accepting new patients |
| Plainville Optical | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 002773 | CT | Yes |
Addresses
Primary practice location
359 Main St
Kensington, CT 06037-2651
Mailing address
359 Main St
Kensington, CT 06037-2651
Phone (860) 829-1020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008035812 | Medicaid | CT |
Other providers in Kensington, CT
- Connecticut Foot Care Centers LLC
- Raphael M Cooper
- Sarah Jane Crisp
- Lina Cultrera
- Amy Lynn Daniele
- John Louis Diakun
- Dr Tosatti Group
- Dr. Lisa M. Arciero OD LLC
- Dr. Mark Diloreto LLC
- Eob II Inc
All providers in Kensington, CT · Optometrist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.