Amanda Khalil, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3030 Issued in CT

Practice address

125 Danbury Rd Ste 8
Ridgefield, CT 06877-4111

Phone

(203) 438-5005

NPI assigned

May 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Ansonia, CT
  • NPI 1396119194
  Medicare reassignment NPD
• Avenue Eyecare LLC

  • Optometrist
  • Greenwich, CT
  • NPI 1912504226
  NPD Authorized official
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Norwalk, CT
  • NPI 1790159408
  NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Vernon, CT
  • NPI 1992207468
  NPD

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659808707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DANBURY RD STE 8",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DANBURY RD STE 8",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774111",
            "telephone_number": "203-438-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17B Governor St",
            "address_purpose": "LOCATION",
            "city": "Ridgefield",
            "state": "CT",
            "postal_code": "068774608",
            "country_code": "US",
            "telephone_number": "203-438-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Maple Ave W",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221804222",
            "country_code": "US",
            "telephone_number": "703-938-5542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "AMANDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3030",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund Karvosky Jr., PHARMACIST
• Erica Georgianne Kasuli, MS, RD, CDN
• Barbara Keefe, PHD
• Keri Spielmann LLC
• Jocelyn Kester, MS
• Eun Hyun Kim
• Tracy A King, LCSW
• Corinne Kingdollar
• Sandra Smith Kirchhoff, LCSW
• Heather Kirk, M.S., BCBA, LBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.