Optometric Specialty Group of Wethersfield, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTOMETRIC SPECIALTY GROUP OF WETHERSFIELD, PLLC

Practice address

185 Silas Deane Hwy
Wethersfield, CT 06109-1219

Phone

(860) 296-1700

NPI assigned

Jun 7, 2018

Last updated

Jun 7, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter Pegolo, ODNPI 1184733255

Title

Doctor

Phone

(860) 236-1218

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

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.

• Nicole Colasurdo Nolan, O.D.

  • Optometrist
  • Wethersfield, CT
  • NPI 1215229273
  Medicare reassignment Care Compare group NPD
• Peter Pegolo, OD

  • Optometrist
  • West Hartford, CT
  • NPI 1184733255
  Medicare reassignment NPD Authorized official
• Andrew J Sokolik, OD

  • Optometrist
  • Wethersfield, CT
  • NPI 1255434734
  Medicare reassignment Care Compare group NPD
• Korab Spahiu, OD

  • Optometrist
  • Waterbury, CT
  • NPI 1801313606
  Medicare reassignment NPD

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1629561428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 QUAKER LN S STE B",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101027",
            "telephone_number": "860-236-1218",
            "fax_number": "860-231-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091219",
            "telephone_number": "860-296-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC SPECIALTY GROUP OF WETHERSFIELD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "PEGOLO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "860-236-1218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Oler, MOTR/L
• Honesty Olivieri
• Martin D Ollenschleger, M.D.
• Chidiebere Onyishi, DNP
• Op Orthodontics of Connecticut PLLC
• Yuri J Ostapiuk, DMD
• Kristen Owczarski, OTR/L
• Debra Ann Pachucki, M.D.
• Melanie Anne Parker, MPT
• Akshay Vasant Patel, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.