Individual provider Active NPI

Philip M Perrino, OD

  • Optometrist
  • New Haven, CT
National Provider Identifier
1639191588
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CT2286 Issued in CT
Practice address
815 Chapel St
New Haven, CT 06510-3001
Phone
(203) 865-6727
Fax
(203) 865-8040
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CT2286 CT Primary

Addresses

Primary practice location

815 Chapel St
New Haven, CT 06510-3001

Mailing address

815 Chapel St
New Haven, CT 06510-3001
Phone (203) 865-6727

Other identifiers 1

IdentifierTypeStateIssuer
004149721MedicaidCT

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
I20080507000194 CT Practitioner - Optometry 7113908500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Connecticut Professional PLLCGroup PAC ID 1658713797, 12 clinicians

Practice addresses (Care Compare)

243 Main St
Durham, CT 06422-1632
Phone (860) 349-2323

815 Chapel St
New Haven, CT 06510-3001
Phone (203) 865-6727

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT2286CTMDOptometrist
002286CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Connecticut Professional PLLC Optometrist CurrentSince Feb 26, 2024 Accepting new patients

Locations

815 Chapel St
New Haven, CT 06510
Phone (203) 644-0038

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1639191588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103001",
            "telephone_number": "203-865-6727",
            "fax_number": "203-865-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103001",
            "telephone_number": "203-865-6727",
            "fax_number": "203-865-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRINO",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004149721",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.