Individual provider Active NPI

Edward L Osborn, M.D.

  • Ophthalmology Physician
  • Torrington, CT
National Provider Identifier
1639156409
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
022860 Issued in CT
Practice address
1151 E Main St
Torrington, CT 06790-3910
Phone
(860) 489-7671
Fax
(860) 482-0410
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 022860 CT Primary

Addresses

Primary practice location

1151 E Main St
Torrington, CT 06790-3910

Mailing address

1151 E Main St
Torrington, CT 06790-3910
Phone (860) 489-7671

Other identifiers 2

IdentifierTypeStateIssuer
001228600MedicaidCT
061044951OtherCTTAX ID

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000353 CT Practitioner - Ophthalmology 5294898821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
022860CTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a Fichman MD PC CurrentSince Nov 1, 2014 Accepting new patients
Richard a. Fichman, MD PC Ophthalmology CurrentSince Nov 1, 2014 Accepting new patients

Locations

178 Hartford Rd
Manchester, CT 06040
Phone (860) 649-9973

1151 E Main St
Torrington, CT 06790
Phone (860) 489-7671

1144 E Main St
Torrington, CT 06790
Phone (860) 489-7671

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229904000000",
    "number": "1639156409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E MAIN ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903910",
            "telephone_number": "860-489-7671",
            "fax_number": "860-482-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E MAIN ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903910",
            "telephone_number": "860-489-7671",
            "fax_number": "860-482-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "022860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001228600",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX  ID",
            "identifier": "061044951",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.