NPIMap

Organization Active NPI

Ophthalmic Consultants of Connecticut PC

  • Ophthalmology Physician
  • Fairfield, CT
National Provider Identifier
1659319598
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
041155 Issued in CT
Legal business name
OPHTHALMIC CONSULTANTS OF CONNECTICUT PC
Practice address
1375 Kings Hwy
Fairfield, CT 06824-5318
Phone
(203) 366-8000
NPI assigned
Jun 3, 2006
Organization subpart
Yes
Parent organization
OPHTHALMIC CONSULTANTS OF CONNECTICUTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Joseph Thimons, ODNPI 1851371454
Title
Vice President
Phone
(203) 366-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 002247 CT
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 041155 CT Primary

Addresses

Primary practice location

1375 Kings Hwy
Fairfield, CT 06824-5318

Mailing address

825 E Gate Blvd Ste 111
Garden City, NY 11530-2136
Phone (516) 804-5200

Other identifiers 2

IdentifierTypeStateIssuer
001411553MedicaidCT
004226115MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820000030 CT Part B Supplier - Clinic/Group Practice 9537133210 Receives reassigned benefits from 8 practitioners
Practice locations: Stamford, CT; Rocky Hill, CT; Ridgefield, CT; Prospect, CT; Norwich, CT; New Canaan, CT; Berlin, CT; Niantic, CT…

National Provider Directory

National Provider Directory
Part of
Ophthalmic Consultants of Connecticut PC

Locations

1375 Kings Hwy
Ste 301
Fairfield, CT 06824
Phone (203) 366-8000

1375 Kings Hwy
Ste 300
Fairfield, CT 06824
Phone (203) 334-2020

1064 E Main St
Ste 318
Meriden, CT 06450
Phone (203) 237-1818

79 Wawecus St
Ste 105
Norwich, CT 06360
Phone (860) 886-0161

60 Waterbury Rd
Prospect, CT 06712
Phone (203) 758-0503

2777 Summer St
Ste 212
Stamford, CT 06905
Phone (203) 975-1818

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1659319598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 KINGS HWY",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245318",
            "telephone_number": "203-366-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC CONSULTANTS OF CONNECTICUT PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPHTHALMIC CONSULTANTS OF CONNECTICUT",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "THIMONS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "203-366-8000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002247",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "041155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001411553",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004226115",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.